The Right Honourable Sir Thomas Clifford Allbutt ... : a memoir

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THE RIGHT HONOURABLE
SIR THOMAS CLIFFORD ALLBUTT

A MEMOIR

MACMILLAN AND CO., Limited

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In 1990.

THE RIGHT HONOURABLE
SIR THOMAS CLIFFORD ALLBUTT

K.C.B.

M.A., M.D., F.R.C.P., F.R.S., IION. M.D., D.SC., D.C.L., LL.D.
REGIUS PROFESSOR OF PHYSIC IN THE UNIVERSITY OF CAMBRIDGE
FELLOW AND SOMETIME CLASSICAL SCHOLAR
OF GONVILLE AND CAIUS COLLEGE

A MEMOIR

BY

SIR HUMPHRY DAVY ROLLESTON

BART., G.C.V.O., K.C.B.

M.A., M.D., HON. M.D., D.SC., D.O.L., LL.D.

REGIDS PROFESSOR OF PHYSIC IN THE UNIVERSITY OF CAMBRIDGE
SOMETIME PRESIDENT OF THE ROYAL COLLEGE OF PHYSICIANS OF LONDON

MACMILLAN AND CO., LIMITED
ST. MARTIN’S STREET, LONDON

1929

BY K

COPYRIGHT

PRINTED IN GREAT BRITAIN
. cV R. CLARK, LIMITED, EDINBURGH

PREFACE

This short life of a great personality was undertaken,
at the wish of Lady Allbutt, with considerable anxiety ;
for not only has it been said that it is as difficult to
write as to live a good life, but full materials for an
accurate account of Sir Clifford Allbutt’s activities,
extending over wide fields and many years, have not
been ready to hand. He kept very few letters, did
not write a diary, or leave any unpublished reminis¬
cences, and very few of his early contemporaries are
now alive. Welcome help, however, has been readily
given, especially by Lady Allbutt, Mrs. H. Cronin,
Mrs. G. P. Bidder, Mr. J. F. Cameron, Dr. W. E.
Dixon, Dr. T. R. Glover, Mr. E. Harrison, Mr. W. E.
Heitland of Cambridge; by Lord Moynihan, Sir
James Crichton-Browne, Dr. A. G. Barrs, Dr. C. M.
Chadwick, Mr. E. Kitson Clark, Professor T. W.
Griffith (about the Leeds period) ; by Sir George
Newman, Sir Walter Fletcher, Dr. Parkes Weber,
Sir Michael Sadler, Sir Henry Gauvain, Professor
Harvey Cushing, Lieut. -Colonel F. H. Garrison,
Professor W. S. Thayer; and by others for letters, to
all of whom, and to Mr. H. M. Barlow for compiling
the Index, most grateful acknowledgements are due.

Sir Clifford Allbutt’s activities naturally fall into

V

VI

SIR CLIFFORD ALLBUTT

three main divisions — early life and education, until
he started in practice in Leeds (1836-61); life as a
hospital physician and consultant in Leeds, terminat¬
ing with three years as a Commissioner in Lunacy,
when he lived in London (1861-92); and the last
thirty-two years as Regius Professor of Physic at
Cambridge (1892-1925).

Though it is hoped that the details of this chrono¬
logical record, derived in the main from published
sources, such as medical and other journals, may
indicate the wonderfully consistent energy, versa¬
tility, wide sympathies, and scholarly culture of this
leader of his profession, it must be admitted that in
some of the earlier years the record has a biblio¬
graphical rather than a biographical character.

H. D. R.

Cambridge,

August 1929.

ILLUSTRATIONS

Right Hon. Sir Clifford Allbutt in 1920 Frontispiece

Book - plate of Professor Clifford

Allbutt ...... Face page 107

Sir Clifford Allbutt in 1911 . . „ 200

EARLY YEARS

(1836-1861)

Thomas Clifford Allbutt was bom at Dewsbury
in Yorkshire on July 20, 1836, the only son and
elder of the two children of the Reverend Thomas
Allbutt, Vicar of Dewsbury from 1835 to 1862, and
later Rector of Debach-cum-Boulge and Rural Dean
of Woodbridge, Suffolk. As the first child born in
Dewsbury Vicarage for half a century or more, the
birth of the future Regius Professor caused great
rejoicing in the parish. A Cambridge graduate (St.
Catherine’s College, B.A. 1833; M.A. 1838), the
Reverend Thomas Allbutt had four sisters and four
brothers; in 1907 and 1923, Clifford Allbutt referred
to his five medical uncles, including a great-uncle, and
the first Medical Directory in 1845, a small octavo
with the motto “L’union fait la force” on the out¬
side (price 5s.), gives the names of two medical All¬
butts, George of Derby, who later moved to Batley,
Dewsbury, and John of Hanley. The Reverend
Thomas Allbutt, like his son when later practising
in Leeds, was a friend of Charles Waterton (1782-
1865) of Walton Hall, the naturalist, Leigh Hunt,
the Wedgwoods, and other literary people. He pub¬
lished “Feeding the Lambs, A Sermon preached in
the Cathedral Church of Ripon, at an Ordination held
by the Lord Bishop of Ripon, on the third Sunday

1836

2

SIR CLIFFORD ALLBUTT

1836 in Advent” (1848, 18 cm., London). Sir Clifford’s
mother was Marianne, daughter of John Wooler of
Dewsbury, whose elder daughters — the Misses Wooler
of Roehead — were on very friendly terms with Char¬
lotte Bronte. The Miss Margaret Wooler so often
mentioned in connection with the Brontes in the
writings of Mrs. Gaskell, T. Wemyss Reid, and F. A.
Layland, died in 1885 at the age of ninety-three with
her mental faculties unimpaired; she kept a school at
Roehead, between Leeds and Huddersfield, to which
the three Bronte sisters went, and to which, when the
school was transferred in 1836 to Heald’s House at
the top of Dewsbury Moor, Charlotte returned as a
mistress. Allbutt knew Charlotte (1816-55), and as a
small boy had seen Emily Bronte; he inherited Char¬
lotte Bronte’s letters to Miss Wooler, and presented
them and an inscribed first edition of Villette (1853)
to the Fitzwilliam Museum, Cambridge. Before he
became perpetual curate of Haworth in 1820 the
Reverend Patrick Bronte (1777-1861) had been a
curate at Dewsbury (1808-11), but before the All¬
butts went there.

In later life Allbutt often insisted that Mrs. Gas¬
kell in her Life of Charlotte Bronte (1857) had been
misled by someone’s account of the West Riding as
a semi-savage region in which these clever girls were
marooned, and so gave an exaggerated impression of
the isolation of the Brontes, who in reality were much
in touch with cultivated neighbours. When in the
spring of 1903 the late Sir Edmund Gosse gave an
address on “The Challenge of the Brontes” at the
annual meeting of the Bronte Society, Sir Clifford
was much interested, and from then onwards collected
material to enable a correct presentation of the real

SIR CLIFFORD ALLBUTT

3

position of the Brontes to be given to the world. He
never published any such account, but when in Leeds
in 1914 he impressed Sir Michael Sadler with the
erroneous view usually taken about the position of
the Bronte sisters; he spoke of Charlotte as quite
commonplace in conversation, as one of those with
the gift of genius attached to an insignificant per¬
sonality, and as “the lamp-bracket which holds the
light”; Emily had probably more genius than Char¬
lotte, but was self-centred and morose, and Anne
tame and imitative. The following letter, written on
April 27, 1924, to the late Sir Edmund Gosse, gives
further evidence of his personal knowledge of the
characteristics of the Bronte family:

My dear Gosse— Let me congratulate not yourself only
but also the world of letters on your Bronte article in to¬
day’s Sunday Times. Am I the only person living who knew
Charlotte and the rest? as well as a boy ever knows a grown¬
up, and not a very expansive grown-up at that.

Charlotte Bronte was a frequent and quite homely visitor
at Dewsbury Vicarage in my father’s time as Vicar, and
my Aunt Miss Wooler was Charlotte’s closest and dearest
friend. I have heard and been familiar with the whole Bronte
“atmosphere” all my life— or all of so much of it as was
contemporary with my Aunts and oldest cousins.

It was not Charlotte Bronte who was “Gey ill to live wi’ ”
but Emily. No human being — and she was surrounded by
the kindest of folk — could get on with Emily Bronte, but
Charlotte Bronte was quite liveable with if you didn’t mind
her being — to us boys — as dull as a “governess” ought to be.
But she was not our governess. Miss Wooler was a woman
of unusual brains and accomplishments, especially a fine
Italian scholar, though Mrs. Gaskell rather sets her down as
no more than a goody-goody. This is the last thing Miss
Wooler was. She was a keen-witted, ironical, and very inde¬
pendent Yorkshire woman, and although startled at first by

1836

4

SIR CLIFFORD ALLBUTT

836 the form of Charlotte Bronte’s first literary venture, yet was
never in any doubt about her rare endowments. I am writing
all this irrelevance to show that I have the “atmosphere”.
Well, to tell me that Bran well Bronte wrote “Wuthering
Heights” is just monstrous. There was never a breath of
doubt about Emily Bronte’s whole authorship, nor of her
ability to do it. I have heard the book discussed for years
in its time, and should have heard any breath of hesitation.
Emily Bronte being a most disagreeable woman — Charlotte
Bronte the only person who could “get on with her” — people
might not have been unwilling to diminish her glory — yet
never a word! So far as I remember, I never saw Branwell
Bronte, and he was rarely spoken of — just silence. Not
merely because he was a bad egg — but because he was not
credited with any of the family ability, or only some phos¬
phorescence of it, he was just negligible, save as a thorn in
other people’s flesh. He seems to have been an irresponsible
and boastful fellow. As to what a woman of genius can
realize in scenes of savagery or degradation — I once dis¬
cussed this with George Eliot in respect of the public scene
in Silas Marner — these folk have some uncanny insight, a
Cuvier-like faculty of ex pede Herculem.

Excuse this enormous and very hurried scrawl (I am
very busy). Kindest regards to Mrs. Gosse and yourself. —
Sincerely yours, Clifford Allbutt.

It was followed by a prompt reply from Sir
Edmund Gosse.

17, Hanover Terrace,
Regent’s Park, N.W.l,
April 28, 1924.

Dear Sir Clifford — Your welcome letter is not merely
very kind and encouraging, but it is definitely valuable as
well. There can be no doubt that you are now the solitary
survivor of those who knew the strange Bronte family per¬
sonally. My dear old friend Lord Knutsford used to talk
to me about Charlotte, and her visit to him. He remembered
the green dress she is wearing in our National Portrait
Gallery picture. But he was born eleven years earlier than

SIR CLIFFORD ALLBUTT

5

you were. How curious it is that there should still be so 1836
much universal curiosity about that bleak and queer trio of
young women at Haworth.

My wife thanks you for your very kind message, and we
both hope you are well. I shall keep your charming letter
as a historical document.

With best regards from yours very sincerely,

Edmund Gosse.

His sister, Marianne Allbutt, who was unmarried,
predeceased him by about nineteen years and was
buried in their father’s grave at Debach-cum-Boulge,
Suffolk, of which he was Rector at the time of his
death. Thomas Allbutt’s second wife was Sarah Isa¬
bella, daughter of Thomas Skelton of Highfield,
Headingley; she was the widow of William Chadwick,
elder brother of Dr. Charles Chadwick of Leeds, and
an aunt of Lady Allbutt; there was no child of this
second marriage. In after life Allbutt acknowledged
the great debt he owed to the example and influence
of his stepmother, and when honours came to him,
expressed regret that his parents, who had made such
sacrifices for him, could not share his pleasure.

The name Clifford was his godfather’s, Edward
Clifford, an artist, who married his father’s sister, and
whose son Edward, also an artist, painted the por¬
trait of Lady Allbutt which, somewhat in the style
of G. F. Watts, is so familiar to those who have been
in the study at Cambridge. Long after, when preach¬
ing the evening sermon in Dewsbury Parish Church
on November 7, 1920, he recalled his childish recol¬
lections of the village of Dewsbury with a beautiful
little beck running through it past the vicarage gar¬
dens, where there were some stepping-stones to the
parish clerk’s dairy-farm on the other side, and so

6

SIR CLIFFORD ALLBUTT

1836 ran on to join the river Calder, where there was a
pretty little strand of silver sand and shells. He then
went on: “When I came back again some time later
for my school holidays, the first thing I did was to
run down to the little strand where we used to play,
and I was very sad to see the dirty slime on the silver
sand and dyes and soaps and all other foul things
swimming down what was our pure rural river Calder.
And from that time, by leaps and bounds, Dewsbury
has grown, as this church has grown, from small
beginnings into a great and populous and wealthy
town — and I had almost said citv. It is not for me to

•j

say what my father’s part in that growth was, but
he had the presence of God’s spirit within him, and
he was one of the practical saints.” In those days the
championship of bell-ringing lay between the ringers
of Dewsbury Parish Church and those of Mottram in
Cheshire; sometimes the prize went to one, sometimes
to the other- — often, Sir Clifford,1 writing in February
1923, believed, to Dewsbury. “On prize competition
days Church Street, Dewsbury, a fairly wide street,
used to be packed with listeners, and very critical
listeners they were. Almost everyone had note-book
in hand to mark errors in the peal, and few escaped
their vigilance. ... It was curious, and not without
historical causes, that the towers were regarded by
the ringers as a domain separate from the church, and
the tenor kept the keys. At Dewsbury a barrel of beer
was on tap in the chamber; and for a ringer to stray
into church must have seemed like a transgression
of the etiquette of his calling.” In another address2

1 Cambridge Itev., 1923, xliv. 230.

2 “The Study of Tuberculosis: a Retrospect,” Brit. Journ. Tuber¬
culosis, London, 1907, i. 5-10.

SIR CLIFFORD ALLBUTT

7

of a retrospective character he recalled the fifteenth-
century vicarage “built in a churchyard and priding
itself over the countryside in the sparkling water ol
its well in the scullery — or should I have written
skullery”. To this “sparkling water” he ascribed the
continued fever for which one of his five medical uncles
treated him by venesection, antimony, and mercury,
and left lifelong scars on his back from blisters.

He was allowed free access to the old-fashioned
surgeries of the two medical uncles in the neighbour¬
hood, and became familiar not only with aromatic
jars and drawers, some of them with quaint old labels,
such as “mummy powder”, “horn of unicorn”, and
“crabs’ eyes”, but with the Lancet. When nine or ten
years old he would sit quiet for hours with the rather
fusty volumes on his knees, fascinated by the wood-
cuts of the mysterious convolutions of the brain, and
by the pungent controversies which were as the
breath of life to Thomas Wakley.

When a small boy it was thought that it would be
well for him to go to the Isle of Wight for a change
from the sterner and gloomier climate of the north,
and he became the child companion of his father’s
cousin, a fragile lady who had gone to Ventnor be¬
cause she had consumption. It was then that he had
his first experience of the treatment of tuberculosis,
and, as he many years later picturesquely described,
was “taught the art of embalming the air by stuffing
cotton wool about the doors and pasting paper about
the window panes.” He received some teaching from
a private tutor there, and then in the summer of 1850
went to St. Peter’s School, York, which is one of the
oldest schools in the country, the oldest school, the
King’s School, at Canterbury, dating back to a.d. 598,

1836

8

SIR CLIFFORD ALLBUTT

1850 the year after St. Augustine’s mission. St. Peter’s,1
founded as long ago as 627, became a boarding-school
during the mastership (750-78) of Albert “the Wise”.
The famous Alcuin, Albinus, or Ealwhine (735-804),
who was born at York, educated at the school and
subsequently its Master (778-82), was a most efficient
educationalist and judge of teaching, for in 796 he
made the previously decadent school at Tours, of
which town he had been created Abbot, flourish so as
to take the same position in France that the school at
York had in England. He highly appreciated his pre¬
decessor’s virtues, and wrote: “Whatever youths he
found of eminent intelligence, these Albert joined to
himself, he taught, he fed, he loved. To some he gave
the art of science, of grammar, and poured into others
the stream of the tongues of orators.” It would
almost seem as if this ancient inspiration influenced
the young Allbutt, who afterwards was most insist¬
ent on the proper use of words. Allbutt went to St.
Peter’s School during the mastership (1844-64) of
the much-beloved William Hey (1811-83), a former
Fellow of King’s College, Cambridge, and subse¬
quently Archdeacon of Cleveland and residentiary
Canon of York, who was a good field naturalist and
entomologist. Allbutt left the school, being in the
sixth form, in 1855. In 1886, when the old Peterite
Club was formed, he was an original Vice-President,
and on June 30, 1903, opened the new science block;
in his address he pointed out that the shortcomings
of English education were in part due to the neglect
of the methods of science, and that as a result the
methods of teaching classics and mathematics were

1 liiiine, A., History of St. Peter's Seltool, York, from a.d. 627 to the
Present Day, 1926.

SIR CLIFFORD ALLBUTT

9

mediaeval. As a boy he had a small laboratory at
home, and with intense curiosity carried out experi¬
ments on rats, thus making his relatives and friends
foretell that he would go in for medicine.

Entering Gonville and Caius College, Cambridge,
on May 31, 1855, Allbutt gained a Caian scholarship
in classics on June 24, 1856, but, as will be seen later,
decided to read science rather than classics; on June
28, 1859, he was awarded a Mickleburgh scholarship
in chemistry, and on June 8, 1860, “a Caian Scholar¬
ship for anatomy, to be made up to £50 for distinction
in Natural Science”. The Mickleburgh scholarship in
chemistry was of the value of £20, and was tenable
till the standing of M.A. Thus Allbutt was a scholar
for the long period extending from Lady Day 1856 to
Lady Day 1863, and it is fairly safe to assume that at
a later date, when eminence in science had come to
be more fully recognized as a claim for reward, he
would have been elected to a Fellowship. Founded in
1756 by John Mickleburgh, B.D., Professor of Chem¬
istry (1718-56), and a former scholar of Caius, this
scholarship was “almost the first with conditions
conceived in the modern spirit, i.e. limited by the
subject of study, rather than by local or family con¬
siderations”.1 The College was then divided into two
sets, one called the “Sims” — an abbreviation for the
followers of Charles Simeon (1759-1836), the evan¬
gelical leader — with strong religious convictions, and
the rest whose “unity depended only on a negative”.

Among his contemporaries was W. H. Dickinson
(1832-1913), who, having entered St. George’s Hos¬
pital in 1851, came up to Caius in 1854 and took the

1 Venn, J., Biographical History of Gonville and Caius College,
1898, vol. ii. p. 325.

1850-

1855

10

SIR CLIFFORD ALLBUTT

1856-

1860

M.B. in 1859; thus began a lifelong friendship between
two men very different in their outward aspects,
Dickinson recalling Samuel Johnson, Allbutt remark¬
able for his courteous distinction. W. B. Cheadle, in
Allbutt’s year and, like Dickinson, a scholar, was
subsequently physician to St. Mary’s Hospital and a
colleague of Dickinson’s at the Great Ormond Street
Hospital. One of his rather senior contemporaries
was John Venn (1834-1923), afterwards President
of the College, whom in an obituary notice Allbutt
described as then “a rather pale, spare, alert, hard-
reading young man with side whiskers and Glad-
stonian collars, after the freshmen of that date”.
Venn had an attack of smallpox and was nursed
under the supervision of Dr. (later Sir) G. E. Paget
(1809-92) in his College bedroom without any at¬
tempt to isolate him or his attendants, thus showing
the state of medical opinion at that time. In the
Caian Allbutt wrote a short obituary of Sir George
Hare Philipson (1836-1918), who entered Caius in
1858 and was afterwards Professor of Medicine and
Vice-Chancellor of the University of Durham. All¬
butt took the B.A. degree in 1859 (proceeding to M.A.
in 1867), and in 1860 the Natural Sciences Tripos as
a Middle Bachelor; he was the only one in the first
class, gaining distinction in chemistry and geology.
There were only six names altogether in the class list,
a great contrast to modern conditions.1 In the previ¬
ous year there had been only three, two in the first
class; Peter Wall work Latham (1832-1923), also of
Caius, with distinction in five subjects — chemistry,

1 In 1928 there were 225 names (42 in the first class, 105 in the
second, and 78 in the third class) in the first part of the Natural
Sciences Tripos, and in the second part 77 names (25 in the first, 35
in the second, and 17 in the third class).

SIR CLIFFORD ALLBUTT

11

physiology, comparative anatomy, botany, and
mineralogy — -a record never equalled; the other
name in the first class was that of George Henslowe,
formerly (1866-90) lecturer on botany at St. Bartho¬
lomew’s Hospital Medical School. Latham, who was
not any relation of the distinguished physicians John
Latham (1761-1843) and his son Peter Mere Latham
(1789-1875), was for a year assistant physician to
the Westminster Hospital, but resigned in 1863 to
return to Cambridge as physician to Addenbrooke’s
Hospital and medical lecturer at Downing College;
eventually he became Downing Professor of Medicine
(1874-94). His son Arthur (1867-1923) was physician
to St. George’s Hospital.

Allbutt went up to Cambridge with literary and
artistic tastes rather more prominent than his scien¬
tific leanings; he was attracted by contrapuntal music
and later was drawn to the Pre-Raphaelite move¬
ment, probably from reading Sketches of the History
of Christian Art (1847) by Lord Alexander William
Lindsay (1812-80), subsequently Earl of Crawford
and Balcarres. He indeed travelled in Italy with some
idea of becoming an artist, but was disappointed with
his power of expressing himself, though no doubt his
artistic feeling played a part in the literary ability so
manifest in his writings and speeches at a later date.
He once gave some hint of this in the aphorismic sent¬
ence: “The best doctor is the best artist, and the best
medical artist is the master, and not the servant of
his science”.1 In connection with the analogy be¬
tween music and medicine it has been pointed out
that in addition to the necessary knowledge of their
science it is essential that technique should be labori-

1 Brit. Med. Journ., 1883, ii. GG1.

1856-

1860

12

SIR CLIFFORD ALLBUTT

1856-

1S60

ously practised; towards the close of his life Allbutt
greatly impressed his medical colleague and attend¬
ant, Mr. Arthur Cooke of Cambridge, by saying: “The
guiding star of my life has been industry, and any
little success I may have had has been due to con¬
stant application” ( vide p. 279).

The almost accidental reading of Auguste Comte’s
Philosophic positive transformed his outlook and de¬
termined his future life by turning his thoughts to
science. Accordingly on November 5, 1858, he entered,
as University men commonly did in those days, the
Medical School of St. George’s Hospital, his friend¬
ship with W. H. Dickinson very probably having also
weighed with him in the choice of a medical school.
By attending the teaching of Sir George Paget and
Sir George Murray Humphry (1820-96) at Adden-
brooke’s Hospital he gained time, and after clerking
in the medical wards for Henry Bence Jones (1814-
1873) and H. W. Fuller (1820-73) at St. George’s
Hospital, and working with J. W. Ogle and Jacob A.
Lockhart Clarke there, he was able to take the M.B.
degree at Cambridge in 1861, the year after he had
done so brilliantly in the Natural Sciences Tripos.
He proceeded to the degree of M.D. in 1869. At this
time, as he mentioned much later,1 candidates for
the final M.B. were not examined in surgery or even
required to be signed up for attendance on surgical
lectures. He never took the University licence to
practise physic, which was not granted until a year
after the M.B., for it had been discontinued in 1859.

But to return for a few moments to his teachers
at St. George’s: Bence Jones was a brilliant and
whimsical personality, and, as a pupil of Liebig,

1 Brit. Med. Journ., 1916, ii. 855.

SIR CLIFFORD ALLBUTT

13

preached the gospel of chemistry in partibus in-
jidelium, in company with W. Prout (1785-1830) and
Golding Bird (1814-54), and is still remembered in
connection with the urinary protein found in multiple
myeloma. While Bence Jones’ clinical clerk Allbutt
was much impressed by a case of acute aortitis which
may first have suggested the aortic origin of angina
pectoris so patiently argued by him from 1895 on¬
wards. Long afterwards 1 he described Bence Jones
as fascinating if somewhat extravagant, invariably
unpunctual, hurrying up the stairs in the hospital
three at a time, while the guineas collected in the
morning, it was said, scattered out of his pockets as
he flew, but an inspiring discipline to be associated
with, and “like sheet lightning”. Fuller was not a
genius, but a kindly, competent teacher of empirical
medicine and like “a fertilizing rain”; he was much
interested in rheumatism and gout, and advocated
the massive alkaline treatment of rheumatic fever
before salicylates were employed.

John William Ogle (1824-1905), who was assist¬
ant physician to the hospital at this time and work¬
ing keenly at pathology and nervous diseases, exerted
a considerable influence on Allbutt; his interest in
the application of the ophthalmoscope 2 to medicine
must have attracted Allbutt to this subject, though
the compelling suggestion admittedly came from
Hughlings Jackson.3 Ogle certainly got him to write
for the British and Foreign Medico-Chirurgical Re¬
view , of which he was editor, and for the now long
extinct St. George's Hospital Reports (1866-79), which,

1 Lancet, 1922, ii. 781.

2 Ogle, J. W., Med. Times and Caz., 1800, i. 572-4.

3 Vide Allbutt, C., Brit. Med. Joum., 1923, ii. 1007.

1858-

1860

14

SIR CLIFFORD ALLBUTT

1858-

1860

together with Timothy Holmes, he founded and
edited. Allbutt began a friendship with George Henry
Lewes (1817-78), which lasted till terminated by
death. He also worked with Jacob A. Lockhart
Clarke (1817-80), who, living in Warwick Street, Pim¬
lico, carried on his investigations on the histology
and clinical features of nervous diseases, though not
on the staff, at St. George’s Hospital; this no doubt
enabled Allbutt to benefit more rapidly than he other¬
wise would have done from the Paris clinic of G. B. A.
Duchenne (of Boulogne), who introduced the term
locomotor ataxia. Acting on Bence Jones’ advice he
spent a year in Paris in post-graduate study, and at¬
tended various clinics, especially that at the Hotel-
Dieu of Armand Trousseau (1801-67), who asked him
to translate his famous Clinique medicale into Eng¬
lish; this, however, he did not undertake, and eventu¬
ally the translation was begun in 1868 by Dr. P. V.
Bazire, who brought out the first volume for the New
Sydenham Society; after his death the series was
carried to completion by the late Sir John Rose
Cormack.

Trousseau, as Allbutt said of him, set a much-
needed example in draining pleuritic and peri-
carditic effusions, for in those far-off days blistering,
not tapping, was in vogue, and it was not uncommon
to see an empyema pointing. This led Allbutt,1 as
will be mentioned later, first to practise and then to
preach the doctrine of draining and opening the peri¬
cardium, and in a letter to Sir Berkeley Moynihan,
written on January 8, 1925, recalled how nearly sixty
years earlier he got the late C. G. Wheelhouse in the

1 Med. Times and Gaz., London, 1866, ii. 474; Lancet, 1869, i. 807;
Brit. Med. Journ., 1870, ii. 31.

SIR CLIFFORD ALLBUTT

15

middle of the night to tap the pericardium in a mori¬
bund young man with rheumatic fever, whose life
was thus saved. While in Paris he also attended
G. B. A. Duchenne’s (of Boulogne) clinic in the
Boulevard des Capucins, Bazin’s and Hardy’s practice
at St. Louis, and formed a warm friendship with
Maurice Raynaud, then interne at the Necker Hos¬
pital, where, forty years before, Laennec had invented
the stethoscope. Duchenne’s influence fed his life¬
long interest in nervous diseases. An attractive
reminiscent account1 of Duchenne (1806-75) ap¬
peared in 1923 over his initials, and this draft of it
was found among his papers:

One summer morning in the year 1860 about 7.30 a.m.,
in the Hotel-Dieu, Tuckwell of Oxford and I, pupils of
Trousseau, were there awaiting the Master when, as he
entered the ward with his usual punctuality, he was followed
by a little, quick, vigilant man whom he introduced to us
as M. le Docteur Duchenne de Boulogne. Duchenne held no
office in the Hotel-Dieu, nor I think at that time in any
hospital of Paris, but Trousseau, with his invariable sym¬
pathetic welcome for colleagues of energy and talents, had
discovered Duchenne and given him free clinical oppor¬
tunities in his wards. Thus Duchenne was fortunate in a
great extension of the field of observation opened out to him,
and in his turn Trousseau was rewarded by much instruction
in a new field of research. Trousseau, as his manner was,
especially to his English pupils, had extended to me a very
kindly welcome; so quickly Duchenne and I became like¬
wise more and more intimate friends. Duchenne’s clinic at
that time was a remarkable crowd; how it was brought to¬
gether and maintained I never quite knew, unless it were
that the magnetism and burning energy of the man, and
indeed the importance of his methods drew people to him
as moths to a flame. His apartment consisted of two or

1860

1 Brit. Med. Journ., 1923, i. 35.

16

SIR CLIFFORD ALLBUTT

1860 three low and narrow rooms or garrets in the mountainous
top of a mansion of flats in the Boulevard des Capucins.
That was not the age of lifts, yet day by day a large con¬
course of cripples from every Department of France clam¬
bered up to his consulting-rooms. How they got there I
cannot imagine; the waiting-room wras full before every visit:
such was the ascendancy of the man. The busy clickings of
the Faradic machines, to which the sanguine little doctor
attributed even more virtue than has since accrued to them,
had also their fascination. Indeed those lively and pene¬
trating machines had much in common with their no less
lively and penetrating master.

The clinic, so far as I could judge from the class of
persons whom I saw there, wras, I suppose, wholly or mainly
gratuitous. Duchenne was too ardent a lover of his work to
make money his first consideration. He kindly encouraged
me to attend his clinic regularly for some weeks, charging
no fee. At that time at any rate I was his only student
visitor and he had then no visible assistant. It wras a wonder¬
ful experience to watch the gradual unravelling under his
discerning eye of the several kinds of palsy which he de¬
scribed to the world later; a demonstration at once of our
ignorance, of the richness of scientific promise, and of the
methods of discovery. But writh these few words I must be
content; my purpose is only to recall some of the earliest
memories of this great clinical investigator. The manifold
and brilliant results of his researches dread no repetition.

In after years we saw a good deal of Duchenne; chiefly
in Paris, once or twice in England. One of his visits was
made on the importunity of Hughlings Jackson, Buzzard,
G. H. Lewes, Gairdner, and myself; Duchenne was to give a
demonstration before a gang of us neurologists. Duchenne
started from home with a portmanteau which may have
contained a few small pieces of raiment, but chiefly a collec¬
tion of diseased bones from certain of his necropsies. This
baggage, after his manner en route, Duchenne managed to
lose, and he arrived in London in much agitation, as well
lie might seeing the nature of its contents; and he became

SIR CLIFFORD ALLBUTT

17

almost frantic when we failed to make light of the peril that 1861
he saw7 before him. We pictured the hubbub which would
arise on the inevitable official examination of the port¬
manteau, for it so happened that about that time human
remains, supposed to be those of a murdered man, had been
found in a carpet-bag dropped into some dark pool of the
Thames. Dear little man; it was wicked to tease him, but he
-was so childlike, so guileless, and so fiery. Happily ere long
the portmanteau was restored to its owner intact, and the
bones had to tell a different story from that which its
anxious owner had imagined.

The result of the teaching at l’Hopital St. Louis
can be traced in Allbutt’s philosophical essay on “The
Significance of Skin Affections in the Classification of
Disease” in 1867.1 Of this and his two other essays
(1888, 1906) on nosology Lieut. -Colonel F. H. Garri¬
son2 wrote: “They are Zukunftsmusik of an aspira¬
tion so exalted as to be, in mathematical phrase,
asymptotic; wonderful visions into the medicine of
the future which it will require post-bellum medicine
(visibly ‘limping across the state line’) many decades
to realize”. In 1861 P. Meniere correlated the three
symptoms of giddiness, vomiting, and deafness — the
Meniere syndrome — with disease of the semicircular
canals in the internal ear, and years later Allbutt3
drew attention to its frequency and obvious char¬
acters, gracefully adding that he did so because it
was not recognized by “men with whom I would
gladly believe myself to deserve comparison”.

In a letter written on November 8, 1916, to Lieut. -
Colonel F. H. Garrison he gave some personal touches
of his early experiences in Paris, and briefly men-

1 St. George's IIosp. Rep., 1867, ii. 187-204.

2 Science, N.Y., 1925, lxi. 330.

3 St. George's IIosp. liep., 1874-76, vii. 111-22.

C

18

SIR CLIFFORD ALLBUTT

1861 tioned the incident of Duchenne’s lost luggage, more
fully told above.

St. Radegunds,
Cambridge.

Dear Dr. Garrison — Your essay on Trousseau if small
in bulk is big with interest, with history, and with fascinating
biographical sketches. I knew Trousseau well, was a pupil
of his — he affected the English student — and was to have
translated his Lectures of the Hotel-Dieu — this did not come
off — I had to plunge into Leeds practising — and heavy fever
epidemics. You will scarcely believe that at the Leeds Fever
Hospital, wiiere both typhus and typhoid were abundant,
my senior colleagues, to a man, scouted my assertion of the
differences. So also the primary contracted kidney (without
large anasarca) was overlooked. I had the honour of intro¬
ducing Trousseau’s paracentesis into the Leeds Hospital
(and so into England?) a task in which I was richly aided
by Bowditch of Boston— my friend and liberal correspond¬
ent. Through Trousseau I knew Duchenne of Boulogne
intimately, a mercurial and delightful person. We got
Duchenne over to London one summer, when I gathered
my friends Lockhart Clarke, G. H. Lewes, Hughlings Jack-
son, W. T. Gairdner, and others to meet him. He brought
over a portmanteau full of bones, and lost it en route and his
terror lest he should be apprehended as a murderer was very
comic and we did not make the least of it, you may be sure.
C. Bernard I no more than saw. Trousseau roused affection
and all the admiration of his pupils, and it was rather a slow
and disconcerting process (as also with Bazin and even Char¬
cot, whom I knew most intimately of them all) to find the
therapeutics which, systematized on paper by the French
genius, was so lucid and convincing fell to pieces in practice.
The vertigo a stomacho lacso (c.g.) was a jumble. — Yours very
gratefully,

Clifford Allbutt.

On returning to England in 1861 lie was some
time in London following the teaching of Sir William

SIR CLIFFORD ALLBUTT

19

Jenner (1815-98), but after consideration decided not
to practise in London but to settle in Leeds, partly
on account of his family’s extensive acquaintance
with Yorkshire people. In after years he received
many flattering overtures to come to London, and
there can be little doubt of the success that he
would have gained had he started there originally or
accepted these offers in the late ’seventies or early
’eighties ( vide p. 96).

1861

AS A CONSULTING PHYSICIAN IN LEEDS

(1861-1889)

1861 When in 1861 he settled in Leeds, where the next
twenty-eight years of steadily increasing activities
were to be spent, he was at once recognized as not
only extremely well informed in all the branches of
his profession but in general and literary knowledge.
It is said that he was regarded as somewhat of a
dandy, and certainly he was always remarkable for
the quiet distinction of his dress. Not strikingly good-
looking in youth, he became more and more hand¬
some as the years went by, and in later life had some
resemblance to the portraits of the first Marquis of
Dufferin and Ava. At first he lived at 13 East Parade
with the late Thomas Marshall, M.A., of St. John's
College, Oxford, who was Registrar in Bankruptcy
and District Registrar, Leeds, and the father of
Horace Marshall, Stipendiary Magistrate for Leeds,
and with the late Edmund Wilson, a solicitor; these
friends had similar literary and musical tastes. Mar¬
shall, who was a remarkably intellectual man, exerted
a definite influence in these early days, as was grace¬
fully acknowledged in his Harveian Oration, on All¬
butt, who characteristically said to a younger man:
“If ever you do get a chance of hearing Tom Marshall
lecture, go”, and this Professor T. Wardrop Griffith
did and found that it was indeed “wonderful”. All-

20

SIR CLIFFORD ALLBUTT

21

butt’s name does not appear in the Medical Directory
for 1862, in which, however, there is the name of
George Allbutt, L.S.A. (1837) and M.R.C.S. (1847) of
Batley, Dewsbury. In 1864 Allbutt had a consulting
room at 12 Park Square, which may still be regarded
as the Harley Street of Leeds.

At the Annual General Meeting of the Leeds House
of Recovery on November 28, 1861, Allbutt was
elected physician to the institution, his senior col¬
league being Dr. Charles Chadwick. This, in spite of a
name rather suggesting a convalescent home, was one
of the early fever hospitals to be established in this
country, and diseases such as typhus and relapsing
fever, now almost never seen, were then commonly
admitted into its wards; at this time it was at Bur-
mantofts, in the outskirts of Leeds, but in 1885 it
ceased to be a charity and was taken over by the
Leeds Corporation, being now at Seacroft. When
opening a Home for nurses at Dewsbury on October
19, 1909, he described the nursing and nurses of more
than forty years before at the Leeds House of Re¬
covery; there were two wards, one for men, the
other for women, each with forty beds, under the
charge of three nurses, two for the day and one for
the night work. “They were great, powerful, red¬
faced women, who all ate a great deal of beef and
drank a great deal of beer, and lifted the patients
as you would lift puppy dogs.” The experience in
the diagnosis of the acute fevers he then gained was
obvious to the end of his life. To illustrate this, refer¬
ence may be made to two events in his later years
in Cambridge; in 1903 there was an outbreak of mild
smallpox, now known as alastrim or para-smallpox,
and there was some difference of opinion as to its

1S61

99

Silt CLIFFORD ALLBUTT

1861 nature; Allbutt rightly decided that the disease was
smallpox, but some doubters contented themselves
by speaking of it as “All-but smallpox”. Again, early
in 1919, when the naval cadets came up to take a
course at Cambridge, and among the sixty who at
once went down with epidemic influenza some mani¬
fested nervous symptoms, he recognized that cerebro¬
spinal fever had broken out. Another early appoint¬
ment he held was physician to the Leeds Dispensary.
Some sixteen years after he began work at the Leeds
House of Recovery, he wrote:1 “When I was first
called to the charge of medical wards nothing startled
me more than the frequent deaths of patients from
fevers and acute diseases, who, to a young observer,
seemed likely to recover. A close perusal of the dead
body gradually convinced me that such deaths are
due not so much to the arrest of the part attacked
or to the intensity of the poison as to some pre¬
existing diminution of the factor of safety.” He then
went on to show that the two organs most likely to
fail were the heart and kidneys. Sixty years later, on
February 17, 1925, only five days before his death,
he wrote to Professor W. S. Thayer, of the Johns
Hopkins Hospital, giving an account of an important
practical point in nursing which he had made out in
these far-off days: “I am just reading Dr. Blumer’s
article on thrombosis in Osier and McCrae’s Modern
Medicine (vol. iv.); and on thrombosis in typhoid
fever (p. 528) you are quoted. When I had charge of
the Leeds Fever Hospital I stopped all typhoid
thrombosis by a simple rule. The patient on conva¬
lescing, as soon as he physically can, tries for relief
by change of his posture, or by turning over, especi-

1 Brit, and For. Med.-Chir. liev., 1877, lx. 279.

SIR CLIFFORD ALLBUTT 23

ally by first lifting one leg over the other. If a right-
handed person, the right leg is put over the left (or
he turns on the left side as the weaker). Then comes
the mechanical cause. These thromboses are all in
early convalescence and generally on the left side.
Direct the nurse not to forbid this change of position,
but to put a pillow between the legs, and arrange the
legs so as not to press on each other. Thus we stopped
all these thromboses.” This precaution, which he had
never seen mentioned in any book or essay, he pub¬
lished for the first time in a letter to the Lancet in
April 1924. About 1867 he resigned the post of physi¬
cian to the House of Recovery and was succeeded by
Dr. J. E. Eddison (1842-1929).

Very soon after his settling down in Leeds, All¬
butt became prominent in the proceedings of the
Leeds Philosophical and Literary Society, and it may
be convenient to mention here his activities in con¬
nection with it. In 1861-62 he was on the Council,
having succeeded T. Pridgin Teale as Curator of the
mammalian collection of the museum, gave a course
of juvenile lectures on the forms of plants and ani¬
mals, and in 1863 delivered a lecture on physiognomy.
In 1874, when a conversazione was held with a special
exhibition of wood engravings and a fine collection of
Bewick’s work, he delivered a lecture on the history
and methods of wood-carving; 'in 1878, when Presi¬
dent, he delivered an address on “The Productive
Career of Great Men”. In 1891, after he had left Leeds,
he lectured on “The Travels of Early Peoples; Trade
and War Routes”, and in 1909 on “Bernard Palissy
as a Pioneer of Natural Science”, a subject which he
expanded in his paper before the International His¬
torical Congress in April 1913 in London dealing with

1861

SIR CLIFFORD ALLBUTT

24

1861 “Palissy, Bacon, and the Revival of Natural Science”.
He was President from 1878 to 1881, being succeeded
by his friend the Reverend John Gott (1830-1906),
Vicar of Leeds (1873-85), and afterwards Bishop of
Truro. At its centenary celebration in 1920, together
with Sir T. E. Thorpe, Dr. J. E. Eddison, and T.
Pridgin Teale, Allbutt was elected an honorary mem¬
ber and recorded his reminiscences.1

On February 22, 1864, he was appointed phy¬
sician to the Leeds General Infirmary on the prema¬
ture death of Dr. Hardwick, who had been appointed
physician in 1860, and in whose memory the “Hard¬
wick Clinical Prize”, to be awarded annually to the
best student in clinical medicine, was founded in
1864. His colleagues were Drs. Charles Chadwick and
John Deakin Heaton. On March 28 ThomasNunneley,
C. G. Wheelhouse, and T. Pridgin Teale (junior) were
elected surgeons to the Leeds Infirmary, and with
Mr. Samuel Hey, who had been surgeon since 1850,
made up the surgical staff. The surgical elections
seem from a letter in the Lancet 2 to have aroused
some ill-feeling among the medical men in Leeds, but
there was not any complaint about Allbutt’s election.
The Leeds Infirmary was founded in 1767 chiefly by
the exertions of William Hey (1736-1819), F.R.S., a
pupil of John Hunter; it was first in a small house,
when Leeds had a population of 17,000, but within
a year a new building was begun and was opened on
the first of March 1771; this, spoken of as the Old
Infirmary, was in existence when Sir Clifford was
elected physician. But on March 29, 1864, the founda-

1 The History of 100 Years of Life of the Leeds Philosophical and
Lilerary Society, by E. Kitson Clark, pp. 131-35, 1924.

2 Lancet, 18G4, i. 396.

SIR CLIFFORD ALLBUTT

25

tion stone of the present Infirmary was laid on a new 1864
site; in 1869 it was opened and was the first hospital
in England to be built on the pavilion system, the
architect being Sir Gilbert Scott (1811-78). Additions
and extensions were made in 1892 and 1916, on the
last occasion no less than five new operating theatres
being erected. From 1767 to 1850 there was always
a William Hey, father, son, and grandson, surgeon
to the Leeds Infirmary, and the reputation estab¬
lished by the first was well maintained, so that,
speaking generally, Leeds was more famous for sur¬
gery than for internal medicine. There was, however,
one medical man who struck out a new line of work
by writing the first systematic account in this country
of industrial disease, the outcome of a great deal of
careful observation. In 1831 C. Turner Thackrah,
whose name does not appear in the Dictionary of
National Biography, brought out a work of 126 pages
with even for those times the unusually long title,
“The Effects of the principal Arts, Trades and Pro¬
fessions and of the Civic States and Habits of Living
on Health and Longevity with a particular reference
to the Trades and Manufactures of Leeds, and Sug¬
gestions for the Removal of many of the Agents,
which produce Disease, and shorten the Duration of
Life”. While often quoting from Bernardino Ramaz-
zini (1633-1714) of Padua, the author of De Morbis
Artijicium Diatriba (1700), Thackrah rightly said
that as “scarcely anything had been published even
on the employments common to England at large”
he had “to enter a new track without guide or
assistance”.

In a reminiscent letter on January 8, 1925, to
Sir Berkeley (afterwards Lord) Moynihan of Leeds,

26

SIR CLIFFORD ALLBUTT

1864 whose address on “The Contributions of Leeds to
Surgery”, delivered on December 8, 1924, on the
coming of age of the University of Leeds, had just
been published,1 Allbutt wrote:

I cannot refrain from teasing you with a letter of con¬
gratulation on your history of Leeds Surgery. It will be a
classic, or at least a locus classicus for the future history of
surgery. I must do more than thank you for your too kind
words concerning myself. Such words from a friend, if too
generous, are none the less very agreeable to read. I was
glad to see full justice at last done to my old friend Mr.
Jessop. He was Resident Medical Officer at the Old Infirm¬
ary when I was elected on the staff, and helped me in scores
of ways, as I was a novice off whom he might have scored
had he chosen to shew off! He made so great a reputation
there (at the hospital) that on commencing practice he was
almost mobbed. ... In those days the Staff operated as a
whole, all putting their dirty fingers into interesting wounds,
and exhaling vapours from their unwashed woollen dressing-
gowns! They frankly criticized each other during operation.

. . . My association with Teale began with ophthalmic and
pleuritic surgery; as a pupil of Trousseau I returned to Leeds
with views about thoracic surgery; and, as Trousseau did his
own thoracic surgery, I was doing likewise; but the phy¬
sicians forbade it, to my only backer’s (Teale) indignation. . . .
You will hardly believe that then pleuritic effusions — even
empyemas — were left to nature. ... It was the impera¬
tive rule that every acute abdomen should be taken first
to a medical ward! I stopped all that, and then as to
effusions William Roberts of Manchester followed very
ably. Then Teale and I took up scrofula. You have no idea
of the curse scrofula was; girls going about like swine,
both sides of the neck levelled up to the jaws; one of our
first, cases — an otherwise beautiful girl of one of the
great Yorkshire houses — was not cleared until “after 14
operations”.

1 Moynilian, 1}., Brit. Med. Journ., 1925, i. 36-39.

27

SIR CLIFFORD ALLBUTT

Lord Moynihan’s tribute to which Sir Clifford 1864
referred ran as follows:

Mr. Tcale and Sir Clifford Allbutt formed the first alliance
known to me in this country. They were pioneers of “team
work”. Sir Clifford, the most deeply learned physician of
this day, master of a style of English which for sheer beauty
and majesty is perhaps unmatched by that of any scientific
author of our generation; an orator whose speech makes
Time seem hasty; a cultured, upright, English gentleman,
is the pride of the school he served so long and loves so well.

Mr. Teale was the authentic product of Winchester and
Oxford, and I know nothing better than that. He was the
flawless example of intellectual and moral integrity. He was
modest, cautious, reserved; free from any jealousies, ready
with words of encouragement, and an occasional word of
praise.

During the busy years, from 1864 to 1884, of
physiciancy to the Infirmary, Allbutt held many
posts in the Medical School, which was founded in
1831. In July 1864 he was elected a member of the
Council of the Medical School, a lecturer in the
Principles and Practice of Physic, Materia Medica,
and Therapeutics, and Curator of the Materia Medica
Museum; in 1866 he also became Lecturer on Com¬
parative Anatomy and held this post until 1878; in
1868 the title of the Lectureship in the Principles and
Practice of Physic was changed to Medicine, and
Allbutt ceased to teach materia medica. In 1875 he
also lectured on Clinical Medicine. These lectureships
he resigned in 1884, when he became Consulting
Physician to the Infirmary, but from 1883 to 1887 he
was President of the Council of the School of Medicine.

The consulting medical practice in Leeds was
practically a one-man privilege; Dr. Hobson, who
was physician to the Infirmary from 1832 to 1842,

28

SIR CLIFFORD ALLBUTT

1864 was in this pre-eminent position, and was succeeded
in this preserve by Dr. Charles Chadwick, physician
to the Infirmary from 1842 to 1871, and when he
retired from practice in 1874 Allbutt naturally took
the lead. Until this time he had to go through the
trying period of waiting, and indeed at one time de¬
bated whether he could hold on, for he had set up as
a consultant from the first. In his address1 at St.
George’s Hospital in 1889, after he had left Leeds and
was a Commissioner in Lunacy, he touched lightly on
his early experiences when speaking of the real ad¬
vantages of youth as seen in retrospect: “I try some¬
times to comfort myself in my age by remembrance
of my tingling resentments when, in the former years
of my practice — and they seem but as yesterday — I
was politely postponed as too young for confidences”.
But he utilized the time by reading widely and writ¬
ing many articles of the nature of essay-reviews in
the Quarterly, the Westminster, and other reviews, and
contributed to the British and Foreign Medico-
Chirurgical Review and to the St. George's Hospital
Reports, these two medical publications being edited
by his friend and former teacher the late J. W. Ogle.
Being thus able to sympathize fully with young men
in a similar position, he in later years often advised
them to sow the seeds of success during these lean
years by reading not only professional but good
general literature, and to hold on, if necessary, as he
expressed it, by “eating their boots”. The habit of
omnivorous reading and making critical notes on
what he read, and thus storing up material for future
use, remained with him throughout life. As he read
he often annotated the books, as is particularly well
1 Allbutt, T. C., Brit. Med. Journ., 1889, ii. 754.

SIR CLIFFORD ALLBUTT

29

shown in his own copies of James Mackenzie’s Future
of Medicine (1919) and monograph on Angina Pec¬
toris (1923); his copy of The Future of Medicine, in
which the general practitioner is held up as being
in the best position to carry out clinical research, is
freely annotated with criticisms showing the difficul¬
ties that attend this ideal. His intellectual activity in
these early days in which, as he afterwards said, he
“was chiefly living on hope”, was most remarkable.
In 1864 he wrote a long article on “Construction and
Degeneration”,1 in two parts, the second with special
reference to the lungs, and in the next year he was
the author of “The Probable Conditions (Past and
Present) of the Lunar Surface”.2 Other evidences of
his consistent industry are given chronologically.

There was founded at Leeds in 1849 a somewhat
exclusive dining club called the Conversation Club,
with twelve members, thus by its title recalling the
famous Cambridge Conversation Society, irreverently
known as “The Apostles”, which veiled all its pro¬
ceedings in modest mystery; Tennyson, Hallam,
F. D. Maurice, and John Sterling were early members
(1828-30), 3 and it is probably referred to by Tenny¬
son in connection with A. H. Hallam in the lines:

“Where once we held debate, a band

Of youthful friends, on mind and art,

And labour, and the changing mart,

And all the framework of the land”.

In Memoriam , stanza lxxxvii.,

and is mentioned in Thackeray’s Book of Snobs.

The Leeds Conversation Club met at the houses

1 Brit, and For. Med.-Chir. Rev., 1864, xxxiii. 509; xxxiv. 34.

2 Quart. Journ. Sc., 1865, ii. 753.

3 Alfred Lord Tennyson: a Memoir by his Son, p. 42, 1897

1864

30

SIR CLIFFORD ALLBUTT

1864 of the members in turn, once a month, for supper,
which, according to the rules, “it is understood should
be simple and inexpensive”, but there is reason to
believe that this understanding became somewhat of
a dead letter, and that there was considerable rivalry
in providing the most attractive hospitality. After an
hour for supper, two hours were devoted to general
conversation. Allbutt’s election to the Club, from
which one blackball excluded, took place on April 26,
1864; he resigned on June 27, 1871, but was re-elected
on December 22, 1885, and finally resigned on April
30, 1889, being the only member of whom, according
to Mr. E. Kitson Clark, there is a record of re-election
after resignation. Among the subjects, during his very
regular attendance, which he proposed for discussion
were: “Is it desirable at once to abandon the trans¬
portation of criminals to Australia?” “Is it desirable
that ladies should remain uneducated?” “Is it vital
for England to prevent Russia occupying Constantin¬
ople?” “Can a novelist do otherwise than reproduce
characters that he has known?” The last subject is
of interest in connection with Sir James Paget’s re¬
mark, when informed by George Henry Lewes that
George Eliot had not any acquaintance in any degree
resembling Lydgate, that “it was like assisting at the
creation — a universe formed out of nothing” ( vide
p. 61). Allbutt was also a member of the Leeds and
County Club, and had an extensive acquaintance
among the lay residents such as the Luptons, Mar¬
shalls, T. S. Kennedy, C. E. Bousfield, John Horsfall.
He was subsequently a Deputy-Lieutenant for York¬
shire. In 1 862 he was one of the founders of the Leeds
Medical Club, which in 1872 became merged in the
Leeds and West Riding Medico-Chirurgical Society.

1866

In this year Allbutt became a Fellow of the Royal
Medical and Chirurgical Society of London and con¬
tributed two papers published in its Transactions :
one on premature menstruation in a child aged 18
months, accompanied by fever which proved fatal; 1
the other, on a ease of myeloid transformation of the
lungs,2 showed, as Drs. Wilks and W. Moxon’s exam¬
ination of fragments of the growth confirmed, the
structure of a myeloid tumour, such as occurs in the
head of the tibia. During this year an historical essay
on the medicine of the Greeks3 appeared from All¬
butt’s pen, and was the product of reading done
during the waiting time which all young consultants
have to go through; the value of this work was shown
by his subsequent papers, especially his FitzPatrick
Lectures (1909-10) on “Greek Medicine in Rome”
more than forty years later at the Royal College of
Physicians of London. A striking feature in his life’s
work was the persistent way in which he returned
to and expanded any subject on which he wrote; this
is well shown by the progressive development and
expansion of the scope of his writings on cardio¬
vascular and nervous diseases, tuberculosis, and
medical history.

1 Med.-Chir. Trans., I860, xlix. 101.

2 Ibid., 1866, xlix. 165.

3 Bril, and Fur. Med.-Chir. Rev., 1866, xxxvii. 170; xxxviii. 483.

31

186(5

32

SIR CLIFFORD ALLBUTT

In November he published a case of pericarditis
with an effusion1 causing such distress that death
seemed imminent; at his request his colleague, C.
G. Wheelhouse, performed paracentesis of the peri¬
cardium with complete success. The pericardium was
punctured with a trocar and cannula instead of em¬
ploying a bistoury, as Trousseau recommended. All¬
butt remarked that this case showed how necessary
it is for a physician to have a useful knowledge of
the resources of the surgeon, and that nothing was
more unfortunate than this division between the two
great departments of the healing art, whereby a mere
arrangement of convenience had been made a real
distinction, thus encouraging at the very outset of
a student’s career a narrowness of thought and an
incompleteness of education, most mischievous to
the best interests of the profession. This artificial
distinction between medical and surgical treatment
was more fully considered by him in the address in
1904 at St. Louis on “The Historical Relations of
Medicine and Surgery”. The surgical treatment of
pericarditis with effusion was thus brought to the
notice of the profession in this country, and subse¬
quently Allbutt returned to the subject on several
occasions.

In 1865-66 there was an epidemic of typhus fever
at Leeds, and he treated a number of cases in the
Leeds House of Recovery with much success by open-
air methods, being supported in this, at that time
rather daring and revolutionary, form of treatment,
for nothing was known of the open-air treatment of
fever cases, which were sheltered and coddled, by
hearing that in Ireland many victims of this disease

1 Med. Times and Gaz., London, 18G6, ii. 474.

SIR CLIFFORD ALLBUTT 33

“laid out on the roadsides to die, unexpectedly re¬
covered, to the great discomfiture of their heirs-at-
law”. During the seven months October 1, 1865, to
April 30, 1866, there were 626 patients admitted and,
excluding those dying within 72 hours of admission,
because so many were admitted in a moribund con¬
dition and kept alive by stimulants and good nurs¬
ing for one, two, three, or, if young, even more days,
the mortality was 8 per cent. All the house physicians
were attacked and three of them died. The cases seen
in private practice were, he noted,1 “on the average
of a more dangerous kind, and the mortality higher.
In persons accustomed to live by the use of the brain
the weight of the disease often fell upon that organ,
causing cerebral and cerebro-spinal disturbances of
an unmanageable and incalculable character, which
tended to death. Among those who lived by bodily
labour and had no brains to speak of, the disease fell
chiefly upon the muscular system, causing failure at
the heart, and general animal and organic prostra¬
tion; symptoms more easy to combat, and more easily
foreseen in their variations and issues.” The measures
adopted were: “(1) an unusual supply of fresh air night
and day throughout the hospital, all fear of draughts
being disregarded;2 (2) regular nursing and feeding,

1 “Notes on an Epidemic of Typhus at Leeds in the year 1865-66”,
St. George's Hosp. Rep., 1866, i. 61-70.

2 On Aprd 15, 1915, when typhus was raging in Serbia, a letter from
Allbutt appeared in “The Times” strongly urging that every typhus
patient should be carried out into the open and that in wet weather
a waterproof coverlid would be sufficient protection. He then recalled
his practice at Leeds, saying that he clothed the staff warmly and had
all the windows taken out of the building or clamped widely open
with screws, and that the mortality of all cases fell promptly from
16U7 to 6-7 per cent. In a letter written in 1870 about the wards he
said: “The nurses had to wear bonnets or other head-coverings, and
the breezes played freely around the beds”.

1866

D

34

SIR CLIFFORD ALLBUTT

1866 and the use, when necessary, of the best cognac
brandy in addition ; (3) prevention by morphia, if
possible, of a second sleepless night, at whatever
stage of the fever it may be threatened; (4) the use
of a combination of camphor and morphia in low
delirium ; and (5) of a combination of tartar emetic
and morphia in wild delirium”. Originally doubtful
about the use of opium in fevers, he found it difficult
to express, without apparent exaggeration, its value,
for though morphine was given freely, no bad effects
were ever observed, and, as he said, “the sleep of an
opiate is better than no sleep”.

As showing the change in the practice of medicine,
it may be noted that he specially quoted six cases in
which the patients’ temperature was taken with a
thermometer at stated times daily — not a routine
practice then. The history of the clinical thermo¬
meter is rather remarkable, for though it was em¬
ployed in the seventeenth century, it did not come
into general use until the second half of the nine¬
teenth century, and then really as a result of All¬
butt’s invention of the present short clinical ther¬
mometer. Sanctorius in 1638 constructed one and
advocated its use in the diagnosis of disease, cor¬
relating variations in bodily temperatures and weight,
and thus was much in advance of his time as a seer
of metabolism; du Val of Paris constructed a clinical
thermometer 3 inches in length and 3 oi 4 lines in
diameter, the central tube for the mercury being half
a line in diameter (Gunther1). This was shown at a
meeting of the Oxford Philosophical Society on May
13, 1684. Van Swieten (1700-72) used Fahrenheit’s
mercurial thermometer, invented in 1720, for register-
1 Early Science in Oxford, 1925, iv. 60.

SIR CLIFFORD ALLBUTT

35

ing the mouth and axillary temperatures. George 1866
Martime1 in 1740 published a remarkable series of
thermometric observations, and James Currie (1756-
1805), of Liverpool and cold bath fame, brought out
a series of observations on clinical thermometry in
1799. In 1852 a clinical thermometer was described
by John Spurgin (1797-1866), physician to the
Foundling Hospital, and Professor William Aitkin
(1825-92) of Netley had used a clinical thermometer
made for him by Casella; but it was 10 inches long
and too cumbrous for general use, “like a short
umbrella”, as Allbutt afterwards described it. John
Davy (1790-1868) in his Physiological Researches
(1863) brought out his observations on the bodily
temperature in various parts of the world, and in
1865 Sidney Ringer published his work on The Tem¬
perature of the Body as a Means of Diagnosis of
Phthisis, Measles, and Tuberculosis. The appearance
in 1868 of C. A. Wunderlich’s Das Verhalten der
Eigenwarme in Krankheiten (translated in the New
Sydenham Society’s Library, 1871) was a stimulus to
the study of clinical thermometry and formed the
basis for an elaborate essay2 on the subject by Allbutt,
in which he includes the history of his short clinical
thermometer. Wunderlich employed a thermometer
nearly a foot long and left it in the patients’ axilla
for 20 to 25 minutes, and most patiently made these
observations for twenty years before he brought out
his monograph. Such a time-consuming process was
not adapted for ordinary practice, and, as already
said, what really rendered its general use possible
was the short clinical thermometer. In 1867 Allbutt

1 Essays and Observations on the Construction and Graduation of
Thermometers and on the Heating and Cooling of Bodies, 1740.

2 Brit, and For. Med.-Chir. Rev., 1870, xlv. 429; xlvi, 144

3G

SIR CLIFFORD ALLBUTT

1866 had made by Messrs. Harvey & Reynolds of 13 Brig-
gate, Leeds, a short clinical thermometer which was
kept in the axilla for five minutes and at first was
6 inches long and cost 7s. 6d. in a case.1 Previously
he had carried it in a wooden stethoscope. A little
later it was shortened to 4 and then to 3 inches, thus
resembling du Val’s instrument in 1683. The experi¬
ment of marking it with the Centigrade scale, intro¬
duced by Celsius in 1742, instead of the Fahrenheit
scale, for which Allbutt expressed disapproval, at
once stopped its sale. The 3-inch-long clinical ther¬
mometer marked with the Fahrenheit scale was sold
in large numbers by Reynolds & Branson of Leeds
and Hawksley of London. A description of Allbutt’s
thermometer was given in the Catalogue of the Museum
of Scientific Apparatus , South Kensington, 1876.

In his account of this typhus epidemic Allbutt
mentioned a point, on which subsequently he often
laid stress, in the following words : “We are now but
just awakening from the metaphysical delusion that
diseases are separate entities; and have scarcely
rubbed our eyes free from the tendency to see in each
disease, or even in each stage of a morbid process, a
fixed species, having no genetic affinities to any other”.

A few months before his death he sent Dr. Alan
Gray of Cambridge some reminiscences2 of Edmund
Schulze and the organ now in St. Bartholomew’s
Church, Armley, near Leeds, which show that among
his varied interests and tastes was a great love of
music and of organs:

In the year 1866 I was climbing in Switzerland with
my old friend and frequent travelling companion, Mr. T. S.

1 Allbutt, T. C., Med. Times and Gaz., London, 1867, i. 182.

2 'The Organ, London, 1925, v. 78.

37

SIR CLIFFORD ALLBUTT

Kennedy, of Meanwood, near Leeds. He had a great love for 1866
Bach and the organ, and had often heard us talking about
Schulze. At the end of a month’s beautiful weather we had
climbed to our heart’s content, and Christian and Ulrich
Aimer had to leave us for other engagements.

While at breakfast we were talking of our plans. Ken¬
nedy suddenly exclaimed, “Let us go and see Schulze”. The
proposal was promptly adopted; we paid our bills and set
out by rail for Coburg, whence we took a carriage to Paulin-
zelle. At that time Pugin the younger was building a house
for Mr. Kennedy at Meanwood. Kennedy was himself no
performer, but as Mrs. Kennedy was a good musician and
pianist, and was taking up organ-playing with enthusiasm
and success, it had been decided that an organ should be
built for the new home.

In the same lovely weather we drove through the up¬
lands and woodlands of Thuringia till we arrived on a certain
hill-top whence we looked down upon a village in a dale not
very far from Weimar; a little way out of the village beside
a stream running down from a glen in the Schwarzburg we
saw the organ works of the brothers Schulze, whose father
had been an organ builder there before them. In a rustic
building with a small water-wheel, little more than a roomy
carpenter’s shop, we were fortunate enough to find the artist
at home; he had just returned from the completion of the
large organ at Soest, in Westphalia. The personal staff
seemed to consist only of Edmund himself, his brother, the
carpenter and cabinet-maker, a labourer or two, and a clever,
gamesome, and rather uncanny black poodle who became
the father of a line of black poodles which afterwards under
such names as Styx, Pluto, Charon, and so forth, was known
long and well in our village. Edmund was a little below
middle height, a slightly built, iron-grey, rather pallid man
with the slight stoop that one often sees in craftsmen. He
was also rather flat-chested, and his aspect suggested a
liability to the pulmonary disease which later brought his
beneficent life to a premature end.

The weather was still delightful, and we passed an idyllic

38

SIR CLIFFORD ALLBUTT

1866 two days with this simple-hearted and gifted family in their
beautiful home; some hours we spent with them on the hills,
some in the humming shop by the little beck, but all in the
spirit of the organ and its great masters. Of these, Edmund
Schulze was one of the chief as an organ creator. He always
denied any skill as an organist, and would never do more
than wander prettily on the keys to test his pipes and build¬
up, and this usually when out of hearing. In the shop was
the carcase and some of the flue work for an order in hand.
On this frame and amid its pipes he would chat with us by
the hour; but the desired secret, the secret of genius, the
magical touch of mind, ear, and finger, remained incom¬
municable.

In these happy hours decisions were soon made. Schulze
& Sons were to build a four-manual organ for Meanwood,
but on a scale too big for the house. Pugin the younger was
therefore to build a tabernacle for the organ near by. The
specification and other conditions were practically settled;
Schulze was to have a free hand, except as regarded the
reeds. Kennedy wished to have the flue-work from Schulze,
but the reeds from Cavaille-Coll, and to this condition
Schulze neither made nor signified any objection whatever.
He spoke with admiration of Cavaille-Coll’s work, and quite
understood Kennedy’s desire to get the reeds from him. So
we were to see Cavaille-Coll in Paris on the way back.

1867

In this year a philosophic essay on “The Signifi¬
cance of Skin Affections in the Classification of Dis¬
ease” 1 appeared over his name; of this and two
further articles on the same subject, Lieut. -Colonel
F. H. Garrison2 wrote: “On this terrain he was un¬
rivalled, his only possible competitor being William
Farr, whose classification of diseases was adopted by
Billings and Fletcher in the Index Medicus In a

1 St. George's Hosp. Rep., 18G7, ii. 187-201.

2 Science, N.Y., 1925, lxi. 330.

39

SIR CLIFFORD ALLBUTT

published clinical lecture1 on the remedial uses of the 1867
Prunus virginiana or American wild cherry, with
some further remarks on diseases of the heart, he con¬
cluded that this drug exerts a special tonic and calm¬
ing power on the arterial system. In May he wrote on
“The Ophthalmoscope in the Physicians’ Practice at
the Leeds Infirmary”,2 reporting on cases of tabes,
epilepsy, and nephritis under his care and that of his
colleague T. Pridgin Teale; he was thus laying the
foundations of his monograph on medical opthalmo-
logy which appeared four years later ( vide p. 56).

His election as a Fellow of the Society of Antiquaries
took place on May 30, but he was not formally ad¬
mitted until January 1890. On June 3 he read a paper
on the prevention of typhus by the improvement of
the dwellings of the poor before the Epidemiological
Society, and mentioned that a company was being
started in Leeds to provide healthy accommodation
at a low rental for the poor, and that a block of build¬
ings had been erected in St. Ann’s Square with an
average cubic space of 980 feet for the rooms.

His father, who in 1862 had been obliged by fail¬
ing health to exchange the Vicarage of Dewsbury,
where he had worked devotedly since 1835, for the
quiet living of Debach-cum-Boulge, near Woodbridge,
in Suffolk, was now taken seriously ill, and his son
hurried to his bedside and watched over him con¬
stantly for the remaining five weeks of his life.

1868

At the Royal Medical and Chirurgical Society on
February 22 he read a paper, with extensive lists of

1 Med. Times and Gaz., 1807, i. 161, 217.

2 Teale, T. P., ibid., 1807, i. 191.

40

SIR CLIFFORD ALLBUTT

1868 clinical observations, on the state of the optic nerves
and retinae as seen in the insane.1 This was the result
of examinations made during the second half of 1867
at the West Riding Lunatic Asylum, Wakefield, and
at the North and East Riding Asylum, Clifton, near
lork. His interest in the morbid anatomy of the
nervous system is shown by the exhibition of two
cases of tumours of the pons varolii.2

In this year he gave the first description of the
histological changes in syphilitic disease of the cere-
bial aiteiics; but this important observation, prob¬
ably because of a feeling of gratitude to one of the
editors, Dr. J. W. Ogle, was modestly published and
somewhat buried in the now long-extinct St. George's
Hospital Reports 3 and did not attract the attention it
deserved, so that Heubner, who wrote on the same
subject in 1874, was widely regarded as the first
observer of the lesion. Heubner, who described the
condition as endarteritis in ignorance of Allbutt’s
aiticle, courteously referred to his work in subse¬
quent papers. Allbutt quoted a letter from Dr. (later
Sir) Samuel Wilks: “I believe I have seen two or three
undoubted cases of syphilitic disease of the arteries.
In all probability it is not uncommon, but the change
in the vessels not being a characteristic one, I cannot
speak with certainty.” This opinion from a foremost
pathologist of the day, who obtained the F.R.S. for
his observations on visceral syphilis, shows the real
advance made in this respect by Allbutt’s microscopi¬
cal observation. In 1872 he showed these microscope
slides before the Pathological Society of London,4

1 Med.-Chir. Trans., 1868, Ii. 97-142.

2 Trans. Path. Soc. London, 1868, xix. 20.

3 St. George's IIosp. Rep., 1868, iii. 55-65.

4 Trans. Path. Soc. London, 1872, xxii. 16.

SIR CLIFFORD ALLBUTT

41

and it may well be that he was urged by his 1868
friends to do so. The pathological aspect of neurology
was supplemented by laborious clinical observation,
especially at the West Riding Asylum, where the
Superintendent, Dr. (afterwards Sir) James Crichton-
Browne, gave him every opportunity in this respect.

A series of six lectures, published during this year, on
“Optic Neuritis as a Symptom of Disease of the
Brain and Spinal Cord”,1 as well as one on “Optic
Neuritis in Pyaemia”,2 showed that he was busily
collecting material for his monograph on medical
ophthalmology published in 1871.

In this year the British Medical Association met
at Oxford with Sir Henry Acland, Regius Professor
of Medicine, as President, and Sir William Jenner as
President of the Section of Medicine. Allbutt read
a paper on locomotor ataxia, and was followed by
his old teachers, Lockhart Clarke and Duchenne of
Boulogne; there was, however, considerable diversity
of opinion, which Allbutt summed up when in the
following year his contribution entitled “Remarks on
the Phenomena of Locomotor Ataxia, with an Ap¬
pendix relative to the Discussion”, was published.3
This is presumably the occasion of Duchenne’s loss
of his baggage containing many pathological speci¬
mens when on a visit to this country ( vide p. 16). In
the autumn he wrote a letter4 about the good results
of the open-air treatment of typhus and typhoid
fevers, and smallpox in the Leeds House of Re¬
covery {vide p. 32), and added that he had never
thought it advisable to try this method in scarlet

1 Med. Times and Gaz., London, 1868, i. 495, 521, 574, 628; ii.

64, 116.

2 Ibid., 1868, i. 691.

4 Lancet, 1868, ii. 814.

3 Brit. Med. Juurn., 1869, i. 157.

42 SIR CLIFFORD ALLBUTT

1868 fever and measles, as it might do more harm than
good. His old college friend W. H. Dickinson and
he corresponded in public with much politeness on
the subject of longevity, the exchange of letters1 ex¬
tending into the following year.

1869

In April he wrote on the subject of dying declara¬
tions,2 giving his experience in criminal cases, and in
May he contributed a long account of the diagnostic
value of the ophthalmoscope in tuberculous menin¬
gitis.3 A number of cases of nervous disease under his
care were also published in this month.4 In June he
followed up the subject of tapping the pericardium,
of which, in 1866, he had been the pioneer in this
country, by a clinical lecture on a case in which para¬
centesis was twice performed, but unfortunately
death supervened.5

Syphilitic disease of the nervous system, to which
he had made a valuable contribution the year before,
was the subject of a further paper containing reports
of eases and a review of current knowledge.6 He also
published a ease of Charcot’s tabetic hydrarthrosis,7
which he had shown to Charcot when he visited Leeds,
and was the first case reported in this country after
Charcot described it in 1868.

In 1869, under the Presidency of Dr. Charles

1 Lancet, 1808, ii. 028; 1809, i. 33.

2 Med. Times and Gaz., London, 18G9, i. 421.

3 Lancet, 1809, i. 590, 032.

4 Med. Times and Gaz., London, 1809, i. 491.

6 Lancet, 1809, i. 807.

“ St. George's Hosp. Hep., 1809, iv. 45-00.

7 Ibid., 1809, iv. 259; Brit. Med. Journ., 1809, i. 157.

SIR CLIFFORD ALLBUTT

43

Chadwick, the annual meeting of the British Medical 1869
Association was held, for the first time in its exist¬
ence, at Leeds, and Allbutt began his many services
to the Association by being secretary to the Medical
Section, of which Dr. (afterwards Sir) W. T. Gairdner,
Regius Professor of Medicine in the University of
Glasgow, was President, and Sir John T. Banks, after¬
wards Regius Professor of Physic in the University
of Dublin, Vice-President, so that there was a gather¬
ing of Regius Professors present and future. The
other secretary was H. C. Bastian, of University Col¬
lege Hospital. Allbutt had staying with him his old
teacher, Lockhart Clarke, W. T. Gairdner, and
William Broadbent. In the Medical Section Allbutt
read a paper on the propagation of enteric fever,1
which after his death was described as “a model of
its kind even to-day” of the elucidation of water¬
borne epidemics of enteric fever.2 It was based on
investigations made in April 1869 into the nature of
the fever prevalent at the Flounders Institute and in
Ackworth, and those made in May of the same year
at Tadcaster. When his paper was published, Dr.
(afterwards Sir) R. Thorne Thorne rather vigorously
criticized the data on which the conclusion of the
water-borne spread of the disease was based. Allbutt
defended himself with politeness and urbanity.
About this time he began to practise gastric lavage
in the Leeds Infirmary after having seen Kussmaul’s
paper on the subject.

On September 15 he was married at Weeton, near
Harewood, to Susan, daughter of Thomas England

1 Brit. Med. Journ., 1870, i. 308, 480.

2 Obituary (unsigned), Journ. Bath, and Bacterial., Edin., 1925,
xxviii. G81.

44 SIR CLIFFORD ALLBUTT

i860 of Headingley, Leeds, the best man being Mr. Alan
Lupton. They first lived at 38 Park Square for a time
and then moved to Lyddon Hall in Virginia Road,
which after they left it was occupied mainly by
medical students of the Yorkshire College, and now,
considerably expanded, accommodates the women
students of Leeds University. They had not any
children.

In December he recommended morphine in the
distress and dyspnoea of cardiac disease;1 this was a
courageous and independent attitude to take up in
the face of the dread it then inspired among his pro¬
fessional brethren who did not employ it in these
cases. Its beneficial effect in cardiac disease was, he
believed, first noticed by his friend T. Pridgin Teale
by the accident of giving a subcutaneous injection
of morphine for a painful ulcer to a patient who also
had heart disease. In practising this new departure,
Allbutt wrote: “From small and timid beginnings I
have gone forward with this marvellous remedy”.
He preferred morphine to opium and gave it, as
already said, by the then comparatively new method
of hypodermic injection, the syringe invented in
1844 by F. Rynd of Dublin not having attracted
attention until in 1855 Alexander Wood (1817-84)
of Edinburgh wrote a small book on the subject of
hypodermic injection for the relief of neuralgia, and
described a syringe constructed on the model of a
bee’s sting. Allbutt had given it in the failing heart
of granular kidney, but did not advise this treatment.
Earlier in the year he had advocated the hypodermic
injection of morphine in dyspepsia,2 believing that
this treatment had not previously been employed;

] Practitioner, 180'J, iii. 342. 2 Ibid., 1869, ii. 341.

SIR CLIFFORD ALLBUTT

45

but in December of the following year, in a further 1869
article,1 he was almost the first to call attention to
the bad effects of repeated injections of morphine,
and referred to a number of neuralgic patients who
were addicts to the habit. As showing the general
professional state of mind when Allbutt was a junior
on the staff of the Leeds Infirmary, it is interesting
to recall that some few years earlier, when hypodermic
medication was in its infancy, the senior physician
solemnly called his colleagues together to consider the
weighty question whether the physician should give
the hypodermic injection with his own hands or call
in a surgeon to perform this function.

1870

In January he published a paper on the ophthal-
mological signs of spinal disease and injury,2 a sub¬
ject included in his great work on medical ophthalmo¬
logy which was nearing completion and came out in
the following year. This year saw the appearance of
his first and very important, because pioneer, paper
“On the Effects of Overwork and Strain on the Heart
and Great Blood-vessels”.3 Though at first accepting
the general opinion that heart disease in the young
was due to acute rheumatism and in the old to ather¬
oma, he had become impressed with the large num¬
ber of cases of cardio-vascular disease in young well-
made subjects, of healthy build, previously unaffected
by constitutional disease, and after a time came to
the conclusion that mechanical strain was an import¬
ant factor in their condition. He gave examples of

1 Practitioner, 1870, v. 327. 2 Lancet, 1870, i. 76.

3 St. George's IIosp. Rep., 1870, v. 23-53.

46 SIR CLIFFORD ALLBUTT

1870 mitral and aortic incompetence and of aneurysm
thus caused, and was surprised to find so little refer¬
ence to this factor in the best works on heart disease.
After mentioning the works of James Hope (1839),
A. B. R. Myers (1870), and of T. B. Peacock (1865),
the last of whom drew attention to the frequency of
cardiac failure among Cornish miners, and ascribed
it chiefly to strain caused by climbing long ladders
at the close of the day’s work, he remarked: “The
only thing I have learnt from my references to about
twenty English authorities is the disagreeable fact
that authors have a calm way of reproducing portions
of the writings of their predecessors without acknow¬
ledgement and apparently without verification”. This
paper was afterwards published separately by Messrs.
Macmillans and translated into German by Doctor
Seitz of Zurich in 1874. This subject he elaborated
in after years in his articles in the two editions of his
System of Medicine (1898, 1909).

On May 3 he attended a commemoration dinner
of the Leeds Philosophical and Literary Society with
one of the original founders of the Society in 1818,
Mr. (afterwards Sir) Edward Baines (1800-90), M.P.,
in the chair. The President of the Society at the time
was John Deakin Heaton (1817-80), M.D., Allbutt’s
senior colleague at the Infirmary.

The Thruston Speech (on the progress of medicine
from the time of Dr. Caius) at Gonville and Caius
College was delivered in the College chapel on May
11 by Allbutt. In this eloquent oration on “The Pro¬
gress of the Art of Medicine”, adorned with quota¬
tions from Greek, Latin, French, and from Whewell,
the great Master of Trinity, he started from Hippo-

1 Lancet, 1870, ii. 37-31).

SIR CLIFFORD ALLBUTT

47

cratic times, and showed first that our theories of 1870
the nature of disease are undergoing a great change,
which must wholly transform our notions of dealing
with it ; secondly, that the new study of pathology or
morbid physiology, while revealing the modes of
disease in the body, likewise points the way to cure
or prevention; and thirdly, with a prophetic eye,
that chemical inquiry is now finding the way into
many of the remoter secrets of function, and is
likely before long to establish some laws of molecular
constitution, which will enable known researches to
be classified, their actions to be explained and calcu¬
lated, and ultimately the construction of some sort of
canon for the discovery and adaptation of remedies,

“an achievement which would at once raise Medicine
into the front rank of intellectual pursuits”. After
insisting that disease is not something with an inde¬
pendent existence, but is “the living body in a peculiar
state”, he went on : “The modern physician — minister ,
non magister naturae— says : ‘The body and its func¬
tions are thrown off equilibrium, and it is not for me
to expel or counteract this or the other, but to put
the body in such a position that it may most quickly
recover its own balance’.” This fundamental prin¬
ciple of the nature of disease Allbutt never tired of
emphasizing. The annual Thruston “Speech” was
afterwards altered into a prize (£54) awarded tri-
ennially to that member of the College (of not more
than fifteen years’ standing from matriculation) who
in the preceding three years has published the best
original investigation in physiology, pathology, or
practical medicine. At the present time the award
takes the form of a medal and a grant for research
in the subjects named.

48 SIR CLIFFORD ALLBUTT

1870 In a published paper1 he insisted on the value in
cachectic cases of syphilis of infusion of sarsaparilla
when given in large doses of one to three pints daily,
as had been the custom at the Leeds Infirmary for a
quarter of a century, instead of the usual dose of one
ounce three times a day. In the course of a letter2
referring to the delay for twenty-four hours of the
effect of chloral, he added : “In valvular disease of the
heart m which I have largely used the hypodermic
morphia, I generally, or at least very often, find the

results of the second night better than those of the
first”.

In “Some Remarks on Paracentesis Pericardii”3
in connection with a case recorded by his friend and
senior colleague the late Dr. J. D. Heaton, in which
paracentesis was not recommended, Allbutt defended
this method of treatment; and after mentioning that,
as far as he knew, the only two cases so treated in this
country had been on his recommendation, recalled
Trousseau’s advice given to him on two occasions :
“If the need ever arise with you, tap the pericardium;
the operation has never yet had a fair trial”. The
operation had, he said, been occasionally performed
on the Continent, but generally in chronic cases as a
last resource, and had “had the success which belongs
to last resources, or indeed something more; for
Trousseau, Champouillon, and Aran had each a suc¬
cessful case, with recovery”. An annotation in the
Lancet in this same month (July), quoted from the
poet Southey’s unpublished journal of a tour in Scot¬
land in 1819 evidence of the value of the open-air

1 Practitioner, London, 1S70, iv. 257.

2 Lancet, 1870, i. 905.

3 Brit. Med. Journ., 1870, ii. 31.

SIR CLIFFORD ALLBUTT

49

treatment of disease. This led Allbutt to write a 1870
letter1 recalling the benefit of free ventilation on the
course of fevers as shown by his plan of treatment
during the epidemic in 1865-66 in Leeds ( vide p. 32).

He mentioned that after he had ceased to be in sole
charge of the Leeds House of Recovery, “routine and
prejudice gained the upper hand”, and his plan of
open windows was abandoned. In August he attended
the annual meeting of the British Medical Associa¬
tion at Newcastle-on-Tyne, and in the Section of
Medicine read a paper2 on a form of functional hemi¬
plegia in connection with pregnancy, nearly always
of the left side; he had noticed that the temperature
was about 1° F. lower on the affected side in these
cases, of which he had seen eight in three years. In
November a clinical lecture on incontinence of urine,3
originally delivered three years before but repeated
with fresh illustrative cases, was published.

As already mentioned (p. 35), it was during this
year that Allbutt wrote an exhaustive essay -re view 4
on clinical thermometry, with special reference to
Wunderlich’s epoch-making monograph on the sub¬
ject, and giving a brief account of his own share in
the introduction of the clinical thermometer. At this
date it was hardly known to general practitioners;
writing in 1903 the late Sir Samuel Wilks5 recalled
having in 1870 requested the Superintendent of
Guy’s Hospital to procure a clinical thermometer,
which when obtained was nearly a foot long. As a
great novelty it was shown at a meeting of the South¬
eastern Division of the British Medical Association,

1 Lancet, 1870, ii. 167. 2 Brit. Med. Journ., 1870, ii. 351.

3 Lancet, 1870, ii. 733.

4 Brit, and For. Med.-Chir. Rev., 1870, xlv. 429; xlvi. 144.

6 Wilks, S., Biographical Reminiscences, p. 143, 1903.

E

50 SIR CLIFFORD ALLBUTT

1870 and excited much curiosity and interest among the
members present, and from one or two ridicule.

Allbutt, who had been an alpine climber since his
Cambridge days, was this year elected a member of
the Alpine Club; he took the keenest interest in
climbing to the end of his long life, contributing to
the Alpine Journal , especially appreciations of the
climbing companions and guides, such as Thomas
Stuart Kennedy, C. E. Mathews, T. G. Bonney, Mel¬
chior Anderogg, and Francois Devouassoud. In his
obituary notice of T. S. Kennedy, with whom he had
climbed for many seasons dating from the early
’sixties, he recorded an exciting adventure: “When
on an easy grass slope we were properly unroped,
while looking at something which interested him he
tripped, fell, and began to roll; in two more seconds
he would have been dashed to pieces on the Viesch
Glacier, some thousand feet below us. Old Christian
Aimer, who was a little ahead, turned at the sound,
and, throwing himself at full length on the grass,
seized Kennedy by the collar, and the honest frieze
(Grindelwald-spun, if I remember aright) held firm.
He silently shook hands with Aimer and turning to
me said: ‘Please never let my wife know of this’.”
After this warning Allbutt, when walking in the
Lakes, carried a stout stick forty-one inches long,
with a prong at the handle; he said, “It has helped
me up many a steep slope”. About alpine climbing
he remarked later in years, “When I felt it was pos¬
sible to slip, I felt it was time to give up”.

Allbutt was one of the twenty contributors,
among whom were Sir Martin Conway, C. T. Dent,
D. W. Freshfield, and T. S. Kennedy, to The Pioneers
of the Alps (2nd edition, 1888), edited by C. D.

SIR CLIFFORD ALLBUTT

51

Cunningham and W. de W. Abney, which traced the
growth and development of mountaineering from the
end of the fourteenth century and provided portraits
and sketches of the lives of the great alpine guides.
In his article on the training of mountaineers he in¬
sisted on careful preparation on the part of alpine
climbers, but said that with these precautions it was,
contrary to general impression, quite suitable for
middle-aged men, as it demanded endurance rather
than speed; and that with a great deal of medical ex¬
perience among alpine climbers he had never had to
advise a sound man to give up alpine climbing alto¬
gether, either on account of age or of any other con¬
dition, and gave examples of octogenarian climbers.
With regard to women he took a different view, as he
had often seen chronic exhaustion, without any local
trouble, result from the attempt to emulate male
climbers. As regards diet he believed in light food
when climbing, and water and plenty of it, but per¬
haps the best drink was cold tea; “milk suits me well
as meat and drink, and has the advantage of combin¬
ing both within itself”.

In a notice of Fran§ois Devouassoud, written in
1917, Allbutt recalled his unpleasant experience in
bad weather on Mont Blanc when his feet were
numbed by frost-bite and he suffered the severe pain
of returning circulation, which, though reassuring as
to the recovery of the frost-bitten feet, left reminders
at every frost. For many years Allbutt climbed in the
Alps, he walked almost every year in the Lake Dis¬
trict, from his fourteenth year, and was a member of
the Fell and Rock Climbing Club of the English Lake
District. He thoroughly believed in a continuous six
weeks’ holiday every year; and in recommending

1870

52 SIR CLIFFORD ALLBUTT

1870 Professor T. W. Griffith early in his career to do so,
he added, I once missed doing so, and I have always
regretted it . When in London he was a member of
the Sunday Tramps”, led by Leslie Stephen (1832—
1904), who was his senior contemporary at Cam¬
bridge and attracted him to alpine climbing. He was
an active member of the Cyclists’ Touring Club, and
even in his last year tricycled about Cambridge, thus,
no doubt, maintaining his remarkable vigour and
health.

1871

Early in the year he was engaged in a correspond¬
ence on medical reform, and in the second and longer
of the two letters,1 which occupied two and a half
pages, he “earnestly called upon the [British Medical]
Association to consider well before it binds anew the
chains of our old bondage”. He also contributed an
article2 on the Bill which the Lancet was bringing
before Parliament to amend the Medical Act of 1858;
this Bill especially urged a radical alteration in the
composition of the General Medical Council, namely,
that its membership should be reduced to twelve,
made up of four representatives of the Crown, four
of the existing licensing bodies, and four of the
medical profession.

Allbutt showed before the Pathological Society
of London3 microscopic sections of the spinal cord
from five cases of tetanus at the Leeds Infirmary; in
three of these, in which the infected wound was in
the foot, he found suppuration extending up the

1 Brit. Med. Journ., 1871, i. 155, 181.

2 Lancet, 1871, i. 178.

3 Trans, Path. Sqc, London, 1871, xxii. 27.

SIR CLIFFORD ALLBUTT

53

sheaths of the posterior tibial nerves, and strongly 1871
urged “neurotomy as a remedial process in tetanus.

... As the central mischief increases rapidly day
by day, it is of the first importance that this or any
other remedial means should be made use of at the
earliest possible opportunity”. It was more than
twenty years later that Gumprecht1 suggested that
the tetanic poison reached the cord by travelling
along the nerves from the point of inoculation. His
specimens were submitted to a small committee
(J. A. Lockhart Clarke and W. H. Dickinson) for a
further report, which Allbutt ventured to criticize,
and accordingly the committee men had another say.
Much interested in the electrical treatment of disease
he published a report2 on cases of infantile paralysis
treated by this method, and a review3 of seven books
on the subject.

The second half of the year was much occupied
in various activities; in July he wrote a short letter
in connection with a correspondence on infection
from the dead,* quoting a case recorded by Virchow
of the transmission of typhus, the explanation of
which is now of course known to be lice acting as
carriers of the Rickettsia. In August he attended the
annual meeting of the British Medical Association
at Plymouth, and brought before the Medical Section
a paper “On Marasmus as an Occasional Consequence
of Enteric Fever”.5 He also continued his report on
cases treated by electricity, dealing in this article
with hemiplegia.6 From his letter7 criticizing the

1 Deutsche med. Wchnschr., 1894, xx. 546.

1 Brit. Med. Journ., 1871, i. 642.

3 Brit, and For. Med.-Chir. Rev., 1871, xlviii. 38-57.

4 Lancet, 1871, ii. 145. 6 Brit. Med. Journ., 1871, ii. 547.

* Ibid., 1871, ii. 262. 2 Ibid., 1871, ii. 83.

54

SIR CLIFFORD ALLBUTT

1871 teleological views of Professor Samuel Haughton
(1821-97) of Dublin, the following sentence deserves
preservation for its light touches: “What Dr. Haugh¬
ton says is said so effectively that it seems as if it
must be right — facts could not resist the charming
of so eloquent an interpreter, and perhaps they follow
his piping as less rigid things once followed Amphion”.

In October, being President of the Medical School
and lecturer on the practice of medicine, he delivered
the introductory address at the opening of the medi¬
cal session of the Leeds Royal School of Medicine.1
The two questions discussed were: “What is Disease?”
and “Can we Relieve it?” A few years before, this
subject had been freely ventilated by Dr. C. Hand¬
held Jones’ article entitled “What are Diseases?”2
followed by letters in the British Medical Journal by
Dr. (afterwards Sir) Samuel Wilks and Dr. (after¬
wards Sir) William Broadbent. Handheld Jones
argued that diseases, which are perturbations of
normal functions, vary so much that great care is
necessary in treating them generically, and, in fact,
seems to have urged the treatment of the patient
rather than of the disease. Wilks,3 on the other hand,
contended that the disease should be treated, and
instanced the abuse of alcoholic stimulation as the
outcome of treating the patient. Broadbent,4 while
agreeing generally with what they both said, tried
to reconcile the two views, and Handheld Jones in
his reply to Wilks, while again deprecating routine
treatment, quoted the old saw in medio tutissimus
ibis, and agreed that the disease as well as the patient

1 Lancet , 1871, ii. 531-35.

2 Brit. Med. Journ., 1808, ii. 29, 345.

3 Ibid., 18G8, ii. 13G. 4 Ibid., 18G8, ii. 34G.

SIR CLIFFORD ALLBUTT 55

should be treated. As he often did in future years, 1871
Allbutt insisted that disease is not “a morbid entity
to be expelled from the body, but a disturbance in
the normal harmony of the constituent parts of the
body. He deprecated the therapeutic nihilism then
prevailing from increased knowledge of the end-
results seen in the post-mortem room, and with real
foresight pointed out the importance of detecting
the first functional deviation from the normal and
finding a means of correcting it; for example, the
information to be obtained in fever from the use of
the clinical thermometer, then in its infancy, and
the benefit obtained from the treatment by cold
baths, practised by James Currie of Liverpool at the
end of the eighteenth century, but then only recently
revived in this country by Wilson Fox.1 In describ¬
ing the nervous habit or constitution he instanced
Mrs. Poyser in George Eliot’s Adam Bede as an
admirable example; two obiter dicta may be quoted:
“Pathologists have found that, after all, they were
physiologists”, and “Physicians are made at the
bedside”. This address, like so many of his, excited
much interest and correspondence, and accordingly
in December he wrote an article on “The Treatment
of Hyperpyrexia by the Withdrawal of Heat”,2 giv¬
ing more detailed information about this method and
recording cases; he had seen twelve cases of high tem¬
perature with delirium in acute rheumatism, two only
with recovery; one of these patients treated in 1866
with morphine, the constant use of which appeared
to be responsible for recovery, was alive and wrote
him a grateful letter of reminiscence in 1900; the other

1 On the Treatment of Hyperpyrexia by Means of the External
Application of Cold, 1871. 2 Lancet, 1871, ii. 880.

56 SIR CLIFFORD ALLBUTT

patient was treated by hydrotherapy in September
1871.

In 1871 and 1873 he published papers1 on the effect
of exercise on the bodily temperature, containing
obser\ ations on himself, with a short thermometer
of his own invention, when climbing in the Alps in
1870. The object was to determine whether or not
the legulating power of the body held good under
great variations of muscular exertion. At that time
he was not aware that any observations of the kind
had been made, but later he found that he had been
anticipated by Lortet, who had carried them out
during an ascent of Mont Blanc in 1869. Allbutt con¬
cluded that the normal effect of prolonged physical
exertion was to raise the temperature slightly during
the day and to favour the early fall of temperature
after the day’s work was over.

His epoch-making monograph, The Use of the
Ophthalmoscope in Diseases of the Nervous System and
of the Kidneys, and also in certain General Disorders ,
appeared in the year of the death of the original
inventor — Charles Babbage (1792-1871) — of the
ophthalmoscope. The practical application to medi¬
cine of this instrument and of Helmholtz’s modi¬
fication had been suggested by Spencer Wells (1818-
1897), who in the ’thirties had attended the lectures
of William Hey, secundus, and T. Pridgin Teale,
senior, at the Leeds Infirmary, and in 1853 started
practice in Brook Street as an ophthalmic surgeon
before he became the famous ovariotomist, and also
by J. W. Ogle. But this was largely carried into
effect by Hughlings Jackson (1835-1911), a brother

1 Proc. Roy. Soc., 1871, xix. 289-90; Brit. Med. Journ., 1871, i. 105;
Journ. Anat., 1878, vii. 100-19.

SIR CLIFFORD ALLBUTT

57

Yorkshireman, who had suggested that Allbutt 1871
should work at medical ophthalmology. It was
therefore natural that Allbutt should dedicate to
Hughlings Jackson this book, which for the first time
provided a really wide and comprehensive review
of this instrument of precision as a diagnostic guide
in clinical medicine. It was obviously the result of
work extending over a number of years; in the
British and Foreign Medico-Chirurgical Review (1868,
xli. 126-150) there is an unsigned review of nine con¬
tributions on medical ophthalmology, which from
its literary style may well have been written by him.

It remarks: “If we rightly remember, Dr. John Ogle
was the first, or one of the first, to call the attention
of the profession in England to the probable results
of ophthalmoscopic examination in cases of cerebral
disease”. With an impartial review of the literature
his monograph contained his own observations made
at Leeds, the North and East Riding Asylum at
Clifton, near York, and especially at the West Riding
Lunatic Asylum, Wakefield, where Dr. (afterwards
Sir) James Crichton-Browne attracted young men
keen on research, such as David Ferrier, Hughlings
Jackson, William Turner, Lauder Brunton, and J.
Milner Fothergill, to work, write for his Reports , and
attend the annual meeting there. Allbutt’s own
observations included primary optic atrophy in
general paralysis of the insane and the condition of
the optic disc in a large number of cases of menin¬
gitis; he noted that the neuritis might subside, and
suggested the term “choked disc” instead of von
Graefe’s “stauungspapille” for the conditions often
seen in intracranial disease. This monograph was
at once recognized as full of sound reasoning based

58

SIR CLIFFORD ALLBUTT

1871 on honest observation, never carrying conclusions
further than the available data justified, and as¬
sembling all the known facts about the subject. The
long and highly appreciative review of the book in
the British and Foreign Medico-Chirurgical Review
(1872, xlix. 429-47), though unsigned, may well
have been by the editor, John W. Ogle, his old
teacher. This important piece of scientific and
literary work is exceptional in that, contrary to his
usual practice, Allbutt never brought out a second
edition or returned at length to the subject. In 1879
Sir William Gowers’ book Medical Ophthalmology
appeared, and passed into a fourth edition in 1904,
when the late Marcus Gunn was associated as author.

1872

On January 2 he showed at the old Pathological
Society of London microscopic sections of syphilitic
disease of the arteries of the brain,1 to which refer¬
ence has already been made ( vide p. 40), and also
specimens illustrating the histology of the nervous
changes in hydrophobia from two cases fatal in the
Infirmary at Leeds in 1871. This disease, about
which so much was written in the eighteenth and
nineteenth centuries, has now as the result of Pas¬
teur’s preventive treatment become rare on the
Continent, and since the Muzzling Order introduced
in 1897 by the late Lord Long of Wraxall, has become
practically unknown in this country. In addition to
a report on the treatment of sick headache,2 he
wrote two letters3 discussing in an independent

1 Trans. Path. Soc. London, 1872, xxiii. 16, 19.

1 Brit. Med. Journ., 1872, i. 47. 3 Ibid., 1872, i. 109, 140.

59

SIR CLIFFORD ALLBUTT

spirit the views expressed in an editorial in the 1872
British Medical Journal on the subject of the elimina¬
tion of poisons; thus the second letter begins: “With
a dexterity which I admire, but cannot hope to rival,
your contributor fastens upon me a false quotation
when from the context it was plain that no quota¬
tion was made or intended”. He also contributed a
paper on “The Causation and Symptoms of the
Choked Disc in Intracranial Disease”.1 In August a
paper of his on thoracentesis2 appeared, and later
in the year he published in the same journal a letter
received from H. J. Bowditch of Boston, Mass.,
confirming the value of early exploration of the
chest, and discussing the proper size of the trocars
for this purpose. He also recorded a case of localized
inflammation of the brain and the meninges, as
shown by an examination after death, which had
caused aphasia.3

As George Eliot’s Middlemarch came out in 1872,
this may be the best place to consider the question
how far Allbutt was the prototype of Tertius Lyd¬
gate. George Eliot certainly knew Allbutt before she
started to write Middlemarch in August 1869; during
her tour in Yorkshire in 1868 she wrote on September
25 to Madame Bodichon: “We went from Leeds to
Bolton; our visit to Yorkshire was extremely agree¬
able; our host, Dr. Allbutt, is a good, clever, and
graceful man, enough to enable one to be cheerful
under the horrible smoke of ugly Leeds”. In another
letter, dated September 20, 1868, to Mrs. Richard
Congreve, she says: “We went to Leeds on Monday

1 Brit. Med. Journ., 1872, i. 443.

2 Practitioner, London, 1872, ix. 75, 320.

3 Lancet, 1872, ii. 140.

60 SIR CLIFFORD ALLBUTT

1872 and stayed two days with Dr. Allbutt. Dr. Bridges
dined with us one day, and we had a great deal of
delightful chat” ( Life of George Eliot, by J. W. Cross,
1884, vol. iii. p. 58). J. H. Bridges (1832-1906),
formerly Fellow of Oriel College, Oxford, at that time
physician to the Bradford Infirmary, was from 1870
to 1898 a medical inspector to the Local Government
Board (the parent of the Ministry of Health); when
a senior scholar of Wadham he had come under the
influence of Richard Congreve (1818-99), one of the
Fellows, and as a result became, with Frederic Harri¬
son and E. S. Beesly, a foremost leader of the positiv¬
ist movement in England. The circumstances and
character of Tertius Lydgate certainly show certain
resemblances to those of Allbutt. Thus Lydgate was
suddenly attracted to medicine by reading a book —
not Auguste Comte’s Philosophic positive, it is true —
but an article on the anatomy of the valves of the
heart in an encyclopaedia; he studied in Paris; settled
down in a provincial town to keep away from the
range of London intrigues, jealousies, and social
truckling; was superintendent of a fever hospital
where he treated fever on “a new plan” with success;
resolved to resist the irrational severance between
medical and surgical knowledge; and showed mental
independence with an aristocratic bearing. On the
other hand, there are, but not very essential, differ¬
ences; Lydgate was an orphan, and the son of a mili¬
tary man; he underwent a medical apprenticeship
and was educated at Edinburgh; he started in Middle-
march in the year 1829; he resigned his post at the
Infirmary in early days and left Middlemarch to
practise with popular success in London and a con¬
tinental spa according to the seasons; wrote a book

SIR CLIFFORD ALLBUTT

61

on gout, “a disease which had a good deal of wealth
on its side”; died of diphtheria at the age of fifty, his
hair having never become white; and always regarded
himself as a failure because he had not accomplished
what he once intended to do. The mentality and
scientific ambitions of Lydgate in 1830 were probably
an accurate representation of Allbutt’s some forty
years later, but the details of Lydgate’s parentage
and other aspects of his life were not those of Allbutt.
It would appear that, though some of the facts about
Lydgate were taken from Allbutt, care was purposely
taken to prevent too obvious a portrait. Sir William
Osier,1 who said that nothing in the careers of Lyd¬
gate and Allbutt was in common save the training
and high ideals, was told by Dr. H. C. Bastian that
George Eliot, during a discussion about Middle-
march, which had then just been published, admitted
that “Dr. Allbutt’s early career at Leeds had given
her suggestions”. It should be mentioned that in a
letter, dated December 5, 1872, to Alexander Main,
quoted in C. S. Olcott’s George Eliot: Scenes and
People in her Novels, p. 164, George Henry Lewes
wrote: “It seemed to him [Sir James Paget] that
there must have been a biographical foundation for
Lydgate’s career. When I told him that she had
never even known a surgeon intimately, and had no
acquaintance in any degree resembling Lydgate, he
said that it was like assisting at the creation — a
universe formed out of nothing.” George Eliot, how¬
ever, as shown above, certainly knew Allbutt. When
this subject was raised in his presence Allbutt pre¬
served a somewhat sphinx-like expression, but never

1 Vide H. Cushing’s Life of Sir William Osier, 1925, vol.i. p.463,
footnote; also Bibliotheca Osleriana, p. 430, 1929.

1872

62 SIR CLIFFORD ALLBUTT

1872 denied it; on one occasion he gave, what for him was
very unusual, a rather self-conscious laugh and said,
“Oh, I think all of us were Lydgate”. It is not un¬
interesting to add that the late Oscar Browning,
whose creation late in life as an O.B.E. was described
in “The Times” as “a piece of heavy bureaucratic
humour”, confessed in his Memoirs of Sixty Years at
Eton, Cambridge, and Elsewhere (p. 193) that George
Eliot often advised him to marry; this general in¬
junction, however, he disobeyed, as he felt “that
Lydgate’s experience of marriage had not been so
successful as to induce the man from whom in some
measure she had drawn the character of Lydgate, to
try the same experiment”.

1873

He published another article on “Overwork and
Strain of the Heart and Aorta”,1 insisting on the
effect of long-continued strain in inducing aortic end¬
arteritis and aortic regurgitation, and also dwelt on
over-exertion as a cause of acute dilatation of the
right ventricle, which he mapped out in his own
person by percussion when brought to a standstill
while climbing the Aeggischorn. When read before
the Clinical Society of London this paper excited a
good deal of discussion. Roy and Adami’s2 later ex¬
perimental results lent support to Allbutt’s thesis;
thus in their 1888 paper: “Of acute overstrain of the
heart from intense muscular exertion, one of us (R.)
has on one occasion had experience: when, during
convalescence from typhoid, he found himself called

1 Trans. Clin. Soc. London, 1873, vi. 101; Lancet, 1873, i. 377.

2 Brit. Med. Journ., 1888, ii. 1321.

SIR CLIFFORD ALLBUTT 63

upon as a medical man to make a fatiguing and rapid
journey with a relieving party over the Mer-de-
Glace to the ‘Jardin’ to attend to a Chamonix guide
who had been severely injured by an alpine accident.
The sensations felt are well described by Clifford
Allbutt, with whose observations on overstrain of
the heart our own results fully coincide. The feeling
of want of breath and fulness in the region of the
heart, as well as the sense of extreme muscular limp¬
ness, are well-marked subjective phenomena. With
regard to the objective phenomena, it did not occur
to the one of us personally involved in this matter
to percuss out his heart, as was done by the more
intelligent Clifford Allbutt, who found the area of
dulness increased.” The two following papers also
show that his alpine holidays sometimes had medical
aspects. In a published note on “Diet in Health and
Disease” he gave a useful piece of advice, evidently
derived from his own experience, to climbers: “A
man will walk fourteen or twenty hours in Switzer¬
land on scrappy food, and then dine or sup heavily,
at 8 o’clock or later in the evening, taking perhaps a
lot of light wine also. Let him, instead, take a large
basin of really good bouillon, and then tumble into
bed. The broth will gently flow into his veins at no
further cost to his own forces, and he will be aston¬
ished to find that he awakes betimes in the morning
fresh, hungry, and ‘game’ for another day.”1 In con¬
nection with a question raised about poisoning by
homoeopathic camphor he related how, while staying
at the Bel Alp, his guide Johann Jaun, when out on
a climb, was taken ill, and the only available remedy
being this drug, borrowed from another climber, it
1 Brit. Med. Journ., 1873, i. 580.

1873

64

SIR CLIFFORD ALLBUTT

1873 was administered by him with a perhaps somewhat
disdainful hand, and brought on decidedly bad
effects— giddiness and nausea.1 It so happened that
about this time he recorded a series of ten cases of
simple giddiness in a communication2 to the York¬
shire Branch of the British Medical Association.
Electrotherapy was a subject in which he took much
interest at this time, and this was abundantly shown
in a long review3 of Duchenne’s (of Bordeaux) Be
V electrisation localisee.

His work at the West Riding Asylum continued
to provide him with useful material, and from a
paper on the obscure neuroses of syphilis,4 the follow¬
ing extract may be quoted :

These cases of syphilis recurring in the after lives of
responsible and distinguished persons are peculiarly dis¬
tressing, and at times it is hard to inquire properly into the
original cause. I have in my note-book the details of another
case also in the person of a clergyman distinguished both
for his abilities and for the charm of his bearing and high
character; to him, of course, the knowledge of his affection
is peculiarly saddening. I need not describe the case, as in
its main features it closely resembles that of others in the
appearance of mental depression, sleeplessness, and neural¬
gia cured by iodides and mercury.

In 1873 the Allbutts adopted Margaret, the
daughter of Thomas England, the eldest brother of
Lady Allbutt. She lived with them until her marriage
in 1899 to the Rev. H. S. Cronin.

1 Brit. Med. Journ., 1873, ii. 673.

2 Ibid., 1873, ii. 86.

3 Brit, and For. Med.-Chir. Bcv., 1873, lii. 319-39.

* West Hiding Lunatic Asylum Med. Hep., 1873, iii. 273.

SIR CLIFFORD ALLBUTT

65

1874

In 1874 the late Dr. Charles Chadwick, who had 1874
enjoyed the bulk of the consultation work, retired
from practice, and Allbutt not only took his consult¬
ing rooms at Park Chambers, 35 Park Square, but
rapidly obtained the premier position as a consulting
physician, and until he left Leeds in 1889 had a
practice extending from the Trent to the Tees. In the
management of his busy consulting practice, arrang¬
ing train times and connections and communicating
with him when already at one so as to fit in another
one in the same direction, he had a most valuable
assistant and factotum in a man called Moore, who
lived with his wife in the house in Park Square where
Allbutt had his consulting rooms on the ground floor.

As a consultant he had the advantages not only
of a fine intellect and a kind heart, but of a presence
and style which marked the great man. His former
colleague, Dr. C. M. Chadwick, the son of Dr. Charles
Chadwick, wrote: “His ‘bedside manner’ could never
have been surpassed; in consultation he always gave
the very greatest satisfaction to everyone concerned;
he was always hopeful, even in the most hopeless
eases, and always left the patient with the feeling
that not only was there considerable cause for hope¬
fulness, but that the patient was the one person, and
the one ease, in which Dr. Allbutt was specially
interested. It is needless to say that all the most
desirable of the general practitioners were both happy
and proud to meet him in consultation. He never
let a man down.” Dr. Frank Mayo, a resident in the
Leeds Infirmary and afterwards in practice in the
neighbourhood, writes: “He inspired the confidence

F

66

SIR CLIFFORD ALLBUTT

1874 of the patient and was very careful to transfer that
confidence to the practitioner he was meeting”. Many
other men now wrell established in practice or retir¬
ing on success have grateful memories of his kindness
and practical help when they were starting on their
professional life. Ever on the look out for new know*-
ledge, he collected from practitioners many personal
observations, especially on prognosis and treatment,
which would otherwise have been lost, and was
always most ready to share his collections with others.
From his long and varied experience of the character
and difficulties of general practitioners in the indus¬
trial towns and isolated districts of Yorkshire, he
became their warm friend, and thus was well quali¬
fied to become the President of the British Medical
Association (1915-20). Scrupulously punctual in
appointments, he would sometimes mention the ex¬
perience during his early days at Leeds of going to a
consultation and finding the late Mr. G. C. Wheel-
house, his colleague, standing on the doorstep, watch
in hand, and his remark: “You are two minutes late;
this is not the way to succeed in life”.

During this year he contributed two thoughtful
papers to the Practitioner,1 the first in January, on
the antipyretic action of quinine, and the other in
November, on the influence of the nervous system
and of arsenic on the nutrition of the skin, with
eighteen illustrative cases. In 1873 Adolf Kussmaul
(1822-1902), whose portrait2 in his later years some¬
what resembled that of Allbutt, described indurative
or callous mediastino-pericarditis with the curious
phenomenon of disappearance of the pulse at the

1 Practitioner, London, 1874, xii. 29; xiii. 319.

2 Vide Annals of Med. History, N.Y., 1926, viii. 101.

SIR CLIFFORD ALLBUTT

67

wrist during inspiration; Allbutt, whose wide reading
always kept him thoroughly up to date, recorded a
case of “Mediastinal Sarcoma simulating Callous
Mediastino-pericarditis”1 in 1874, and thus directed
attention in this country to the condition. In Novem¬
ber he also wrote on “The Modes of Death in the
Earlier Stages of Scarlet Fever”,2 based on lectures
given in his winter course on the practice of medicine.

1875

Under the title of “A Clinical Thermopile”3 he
published an account of a thermo-electric apparatus,
made by Messrs. Harvey & Reynolds, of Leeds,
which he had used since 1868 for recording surface
temperatures. In his last years he often spoke to
Dr. P. C. Varrier-Jones4 of his share in the invention
of a self-registering continuous recording thermo¬
meter; but though he searched among his papers he
was unable to find his description of it. In August
he attended the annual meeting of the British Medi¬
cal Association at Edinburgh, under the presidency
of Sir Robert Christison, and read a paper on “Auscul¬
tation of the Oesophagus”,5 confirming some of the
observations made in 1867 by Hamburger, almost
the only authority on this subject, and giving an
account of the normal sounds produced on swallow¬
ing and of their modification in disease.

1 Brit. Med. Journ., 1874, ii. 300.

2 Lancet, 1874, ii. 652.

3 Brit. Med. Journ., 1875, i. 300.

4 The Significance of Temperature Variations in Tuberculous
Disease, p. 10. Cambridge, 1926.

6 Brit. Med. Journ., 1875, ii. 420.

1874

1876

68 SIR CLIFFORD ALLBUTT

1876

Although much occupied in consulting practice
he did not relax his activities in other directions; in
January he contributed some “Notes on Dr. Broad-
bent’s Lectures on the Pulse”,1 which had been de¬
livered in the previous year at St. Mary’s Hospital,
and dealing with its diagnostic, prognostic, and thera¬
peutic indications.2 Allbutt wrote that six years
previously, when rather disheartened with his experi¬
ence of the sphygmograph as an instrument of clinical
research, he had been encouraged by the late Dr. F. E.
Anstie’s remark that its great value was not so
much in the detection of cardiac lesions as in facilitat¬
ing a better appreciation of constitutional states.
Broadbent’s lectures therefore appealed to him as
valuable on this account; but he thought that suffi¬
cient stress had not been laid on the importance of
worry in the production of high blood-pressure, a
point in which he was at this time much interested.
In April, an essay-review, after the manner of the
Quarterly Review, appeared by him and was really an
essay on diabetes,3 though based on five books deal¬
ing with that subject.

At the annual meeting of the British Medical
Association he read a paper on “Mental Anxiety as
a Cause of Granular Kidneys”,4 which was important
not only from the point of view of the subject but
also because it showed that lie was working at the
early stages and the causes of disease which Sir
James Mackenzie, some forty or more years later,

1 Lancet, 1876, i. 86.

2 Broadbent, VV. II., ibid., 1875, ii. 441, 549, 583, 901.

3 Brit, and For. Med.-Chir. Rev., 1876, lviii. 353-69.

4 Brit. Med. Journ., 1877, i. 157.

SIR CLIFFORD ALLBUTT

69

insisted on so strongly and investigated at the St. 1876
Andrews Institute for Clinical Research, now the
St. Andrews (James Mackenzie) Institute for Clinical
Research. Allbutt began his article by saying that
for the purpose of tracing the causes of disease he
had taken “more or less careful notes” of almost all
the patients he had seen for some years, and thus had
the records of nearly a thousand cases from which
he drew the following conclusions: Hardly any case
can be regarded as trivial, for a disorder, however
slight it may be, forms an important link in the life
history of the individual; skin diseases were import¬
ant, and to them were allied conditions which might
be called eczema of the bronchial mucosa and psori¬
asis of the tongue and colon; the hereditary and
familial nature of rheumatic fever and gout in com¬
bination. As regards the subject of his paper he found
that among thirty-five cases of granular kidney
twenty-four had a well-marked history of prolonged
mental anxiety, which he therefore concluded was
one of the chief causes, if not the chief cause, of that
disease. This early clinical observation is of much
interest in connection with his later views on high
blood-pressure as a cause of arteriosclerosis, and
of the association of arteriosclerosis and granular
kidneys. In his Harveian Oration for 1912, entitled
“The Passing of Morbid Anatomy”, the late Sir
James Goodhart, who thought and wrote much in
the same attractive style as Allbutt, said: “Long
years ago our trusty Fellow, Sir Clifford Allbutt,
now Regius Professor of Physic at Cambridge, wrote
a short paper on ‘Mental Anxiety as a cause of
Granular Kidney’. It was to me one of those illumin¬
ating suggestions that have added an interest to my

70 SIR CLIFFORD ALLBUTT

1876 life. I believe it to be as abundantly true as I do that
similar malign influences, by dislocation in some
way, as I suppose, of our correlated impulses, make
for cancer. You must have often seen the nervous,
anxious, worried man, with the phenomena of high
tension, and have felt able to predict, in posse , the
future disease of this organ or of that. Such condi¬
tions, real diseases though they may be, are but func¬
tional, but what a wealth of pathology is wrapped
up in them!”

It may be mentioned that among the cases on
which the late Sir James Paget based his classical
paper before the Royal Medical and Chirurgical
Society on November 14, 1876, entitled “On a Form
of Chronic Inflammation of the Bones (Osteitis
deformans)”, was one which Allbutt had observed
and sent to Paget. This is one of the diseases with
the eponym of “Paget’s disease”.

1877

In the late ’seventies he advocated the treat¬
ment of pulmonary tuberculosis at Davos,1 years
before the open - air treatment became popular,
though it had been practised in 1840 by George
Bodington of Sutton Coldfield in Warwickshire,
who was regarded as a crank, and fifteen years later
was again carried out by Henry MacCormack (1800-
1886) of Belfast. Indeed, it was not until it had been
employed abroad by Brehmer (1859) of Gobersdorf
in Silesia, by E. L. Trudeau (1884) in the Adirond-
acks, and others, that about 1895 it attracted much

1 “Davos as a Health Resort,” Lancet , 1877, ii. 575; 1878, i. 824;
1879, ii. 7(>, 118.

SIR CLIFFORD ALLBUTT

71

attention in this country. On his first visit to Davos 187
in 1S77 Allbutt arrived there with John Addington
Symonds (1840-93), who, being seriously ill with
pulmonary tuberculosis, had been advised by Sir
William Jenner to go to Egypt, but hearing of the
alpine treatment, decided to try Davos first; he then
placed himself under Allbutt’s advice as to the
future, with the result that he practically made it
his home with most beneficial results for both his
health and his literary activities. Throughout his
life Allbutt retained a keen interest in tuberculosis,
as is shown by his opening a discussion on “The
Prevention and Remedial Treatment of Tuber¬
culosis” at the meeting of the British Medical Asso¬
ciation at Portsmouth in 1899,1 by his activities as
a member of the consulting staff of King Edward
VII. Sanatorium at Midhurst from its opening in
1906 until his death; at Papworth (1918-25), and
by addresses elsewhere, for example, on the sun
treatment at Sir William Treloar’s Cripples’ Hos¬
pital and College at Alton in Hampshire in 1923
on the conservative surgery and sun treatment
there.

Early in the second half of the year he read a
paper before the Yorkshire Branch of the British
Medical Association on uraemic asthma,2 a condition
not then widely recognized; he appears to have been
then, when to give morphine in any form of renal
disease was regarded as a grave mistake and most
reprehensible, secretly drawn to do so, for he wrote:
“Perhaps we ought, in extreme cases, to inject a
little morphine under the skin, but this I dare not

1 Brit. Med. Journ., 1899, ii. 1149.

2 Ibid., 1877, ii. 407.

72 SIR CLIFFORD ALLBUTT

1877 recommend”. As a matter of history the use of
morphine for the relief of uraemic manifestations
had been advocated in 1873 by A. L. Loomis1 in
America; but so strongly was the teaching of author¬
ity, and perhaps especially that of the late Sir
William Jenner, a forcible personality, opposed to
it, that it was not until the late Sir Stephen Mac¬
kenzie" in 1889 showed the benefit and harmlessness
of treating uraemic asthma by hypodermic injection
of morphine that this mistaken doctrine began to
lose ground. On August 9 at the annual meeting
of the British Medical Association at Manchester,
Allbutt read a paper3 in the Section of Medicine, of
which the late Sir William Jenner was President, on
the treatment of pleuritic effusion, a subject in
which he had taken an active interest, preaching
Trousseau’s plan of tapping before it became a
general practice, since he set up in Leeds. A little
later in the year he recorded a case of hyperpyrexia
in rheumatic fever with recovery after hydrotherapy4
extemporized in a large house far in the wilds of
Yorkshire, thus repeating his successful experience
recorded in 1871 (z ride p. 55). About the same time
he loyally wrote a brief letter5 supporting Charcot’s
claims with regard to metalloscopy and metallo-
therapy, which were then exciting a good deal of
critical incredulity.

In October he contributed an analytical and
critical review containing statements of his own
views on the pathology of granular kidney. This ap¬
peared in the last number of the British and Foreign

o

1 Med. Itec., New York, 1873, vii. 301.

2 Lancet, 1889, ii. 208, 263.

3 Brit. Med. Journ., 1877, ii. 720.

1 Ibid., 1877, ii. 002. 5 Ibid., 1877, ii. 052.

SIR CLIFFORD ALLBUTT

73

Medico-Chirurgical Review,1 and was an essay-review 1877
written round three important publications on the
subject, George Johnson’s Lumleian Lectures at the
Royal College of Physicians of London, W. H. Dick¬
inson’s book on renal disease, and the articles on
diseases of the kidney in the translation of von
Ziemssen’s Encyclopaedia of Medicine, all published
during the year.

1878

To the first number of Brain 2 in April he contri¬
buted by invitation, and, while regretting that from
force of circumstances he was unable to bring for¬
ward any laboratory observations, wrote a vigorous
condemnation of the evils of “brain-forcing” in
schools, a subject on which he had long wished to
speak out. “Almost daily”, he said, “I am in con¬
tention with parents and guardians, schoolmasters
and schoolmistresses, clergymen and professors,
youths and maidens, boys and girls, concerning the
right way of building up the young brain, of ripening
the adult brain, and of preserving the brain in age.”
So often was mental development latent during the
period of physical growth that he had much sym¬
pathy with dunces, and was a firm believer in a
vigorous physique. Precocity was gained at the cost
of feeble maturity and early decay, and “the mis¬
chief done daily by calling upon the unripe brain
for productive work, for original composition, for
competitive examinations, for teaching and even
for preaching, was calamitous”. Schoolmasters, as
a class, were utterly unconscious of the existence of

1 Bril, and For. Med.-Chir. Rev., 1877, lx. 279-98.

2 Brain, London, 1878-79, i. 00-78.

74 SIR CLIFFORD ALLBUTT

1878 the science of physiology, and he declared that “be¬
fore women can hope to do hard and high work, sense
must expel sensibility, and schoolgirls must cease to
walk out in a row, to veil their faces, wear stays, and
to eat delicately”.

In 1878, now well known as “Allbutt of Leeds”,
he took the membership of the Royal College of
Physicians of London, and, being over forty years
of age, was, according to the existing by-law (now
altered), excused part of the examination. Being
markedly independent, he had probably not thought
it necessary to become a member of the College; but
about this time the College, under the presidency of
Sir James Risdon Bennett (1809-91), made consider¬
able efforts to bring into its fold all university gradu¬
ates practising medicine in the provinces, and it may
well be that Allbutt was specially approached by
some of his London friends. It is historically interest¬
ing that his junior, William Osier (1849-1919), then
physician to the Montreal General Hospital, was
admitted to the membership at the same Comitia
of the College on July 26; for there thus began a
certain parallelism in the careers of these two great
humanists, scholar-physicians, and future Regius Pro¬
fessors, who were appointed at almost the same age,
fifty-six and fifty-five, at Cambridge and Oxford.
After the interval of five years, four being the possible
minimum, they were elected Fellows of the College
in 1883, the Goulstonian Lectureship, which falls to
one of the four junior Fellows, being allotted to
Allbutt. It is a curious coincidence that they both
were Goulstonian lecturers, for by an unprecedented
action the College Comitia refused to accept the list
of Fellows nominated by the Council, and there was

SIR CLIFFORD ALLBUTT

75

therefore no election of Fellows in 1884. The reason 1878
for this rebellion was that the name of a then rising
physician, Samuel West (1848-1920), was not in¬
cluded among those recommended by the Council;
the explanation of his exclusion was thought, and
almost certainly correctly, to have been his position
on the staff of the Royal Free Hospital, Gray’s Inn
Road, where pupils of the London School of Medicine
for Women, established in 1874, did their clinical
work. The President of the College, Sir William
Jenner (1815-98), a dominating personality, was
strongly opposed to women doctors, and indeed had
openly expressed his feeling by saying that he would
rather see his daughter dead than a medical woman.
West’s friends, led by the late James Andrew (1829-
1897), then senior physician at St. Bartholomew’s
Hospital, felt that this was not fair dealing and ac¬
cordingly refused to accept the list proposed by the
Council. West was elected a Fellow of the College in
the following year (1885), and was afterwards phy¬
sician to St. Bartholomew’s Hospital. Osier, who
meanwhile (1884) had become Professor of Clinical
Medicine at the University of Pennsylvania, Philadel¬
phia, being still the junior Fellow, followed Allbutt as
the Goulstonian Lecturer for 1885, and gave the first
comprehensive account in English of malignant en¬
docarditis, a subject also taken forty-one years later
for the Lumleian Lectures (1926) at the College by
Sir Thomas Horder, who in 1909, at the same time
as Osier, was then bringing the subacute or chronic
form of bacterial endocarditis before the notice of the
profession. Further coincidences are that Allbutt
(1900) and Osier (1906) both gave the Harveian
Oration at the Royal College of Physicians of London,

76

SIR CLIFFORD ALLBUTT

1878 though this is perhaps an almost inevitable honour
for such Regius Professors, and edited successful
Systems of Medicine. F. H. Garrison,1 in comparing
these two Regius Professors, wrote: “Allbutt was, in
fact, the spiritual aristocrat, just as Osier was an
essential democrat in professional relations, gregari¬
ous and fond enough of people to be sometimes
victimized by them”.

On taking the chair as President of the Leeds
Philosophical and Literary Society, an office he held
for three years, Allbutt gave an address on “The Pro¬
ductive Career of Great Men”. From a review of the
lives of great poets, prose writers, painters, musicians,
and scientific men he placed the age of greatest mental
achievement somewhere between forty-five and fifty,
and came to the conclusion that it was not until the
age of forty that any man reaches the full perfection
of such powers as he may have by inheritance or
acquirement. In connection with Osier’s dictum, in
his well-known address “The Fixed Period”, de¬
livered on February 22, 1905, that the effective work
of the world is done by men between twenty-five and
forty years of age, Allbutt referred to this subject
again in the introductory address at King’s College
Hospital at the opening of the winter session on
October 3, 1905, entitled “Medical Education in
London”, and subsequently published in book form
by Macmillans in 1906.

1879

In August the British Medical Association held
its annual meeting at Cork, and Allbutt read two
papers in the Section of Medicine, which were pub-

< Science, New York, 1925, lxi. 881.

1

SIR CLIFFORD ALLBUTT

77

lished in the British Medical Journal in the following
year, not nearly so satisfactory an arrangement as
that now customary, whereby all the reports of the
annual meeting are disposed of before the end of the
year. His “Remarks on Dilatation of the Stomach
and its Treatment”1 referred specially to washing out
the stomach; to this method he was early attracted
by Professor Adolf Kussmaul’s advocacy in 1869;
later, he described his early experience:2 “When, on
the first appearance of Kussmaul’s paper, I begged
a lady of atonic fibre, afflicted with gastrectasis due
largely to an abuse of aerated waters, to allow me
to wash the stomach out, I begged in vain. Even
hospital patients resented it at first; but at the pre¬
sent day, men and women of refinement take to
lavage as naturally as after a like period of shyness
they did to morphia injections. ... In 1869 the
stomach-pump was the means of lavage; soon after¬
wards a syphon, such as is now used, was made for
me by Messrs. Harvey & Reynolds, of Leeds, and the
same improvement soon suggested itself to other
physicians.” This illustrates his readiness to invent
and adopt instruments, as was shown by his earlier
introduction of the present short form of clinical
thermometer in 1867, and expressed in 1881 in his
inaugural address to the Midland Medical Society at
Birmingham, “On Surgical Aids to Medicine”. His
other paper at the Cork meeting of the British Medi¬
cal Association was “On Aortic Regurgitation and
the Coronary Circulation”,3 and evoked a dissentient
letter from Sir Richard Douglas Powell.

1 Brit. Med. Journ., 1880, i. 315.

2 System of Medicine, 1807, iii. 512,

3 Brit. Med. Journ., 1880, i. 840.

1879

78

SIR CLIFFORD ALLBUTT

1880

1880 The Allbutts went to Grange for Easter, but on
Easter Sunday he hurried back to Leeds to join Dr.
J. E. Eddison in consultation on their senior colleague
Dr. J. D. Heaton, who was dying from pneumonia.
Allbutt wrote: “I must not speak of my regrets in
the midst of your own terrible sorrow, but I cannot
refrain from saying that Dr. Heaton’s loss to me is
one which I feel very deeply. As I returned hither
feeling very sad, I remembered all his goodness and
usefulness as I had seen them for twenty years past;
his unswerving rectitude, his generous fairness and
welcome to his juniors, his kindly hospitality and
thorough sincerity; all of which I can never forget.
He was a leader with whom one always felt safe, and
there is no rarer quality than this. On public grounds
his loss is simply irreparable.”1 When in 1893 he
delivered for the third time the introductory address
at the Leeds School of Medicine, he paid a high
tribute to his late colleague’s public services, and
said that no one who knew him would have hesitated
to place his honour or his interests in his hands, even
if the personal interests of his judge were concerned
in the issue, and that “this means a great thing; it
means not only integrity of mind, not only purity of
heart, but it means also imagination enough to see
how to do as you would be done by”.

The scandal of medical men, appearing as expert
witnesses, contradicting each other about facts in
courts of justice was obviated in Leeds by Allbutt’s
wise tact in getting the profession together. At a

1 Memoir of Dr. John Deakin Heaton , edited by T. VVemyss Reid,
1883.

SIR CLIFFORD ALLBUTT

79

meeting it was agreed to combine in refusing to give
evidence in legal cases unless a consultation of both
sides was arranged before the case came on in court,
even if this were — as often it was — very shortly before,
as many witnesses came from a distance. As a result
the medical witnesses, though frequently differing in
opinions, did not disagree much about the facts. This
course was at first met “with bitter opposition from
the lawyers — open from the solicitors, covert from
the Bar, because it tended to cut down fees, or to
show less for them”. . . . “But some of the larger
legal firms approved our ruling, and even applauded
it; so did gradually the leading counsel. The amend¬
ment became apparent to all, and ere long we had
all cordially with us. The evidence was immensely
improved in both quality and consistency; new facts
or new interpretations came out; and doctors of
less experience were not sorry to accept a more
adequate diagnosis, or partial modifications.”1 The
result of this was shown by Mr. Justice Fitzjames
Stephen’s remarks, as quoted in the following an¬
notation in the British Medical Journal (1880, ii. 354):

Dr. Clifford Allbutt (Leeds) and Mr. W. A. Statter (Wake¬
field) gave evidence at Leeds Assizes before Mr. Justice
Stephen, relative to the injuries which a young lady re¬
ceived in a railway accident on the Lancashire and York¬
shire Railway. At the close of the case, says the Yorkshire
Post, his Lordship paid a very high compliment to those
gentlemen, and to the leaders of the medical profession in
Leeds generally. He said the medical evidence by Mr.
Statter and Dr. Clifford Allbutt was a pattern of what such
evidence should be. He was in the habit of hearing medical
evidence in all parts of the country, and Leeds was the only
town where he never heard those unseemly disputes between
1 Allbutt, C., Brit. Med. Journ., 1922, ii. 1245.

1880

80 SIR CLIFFORD ALLBUTT

1880 the legal and medical professions which occurred at other
places. Here there was a certain number of gentlemen, the
leaders of the medical profession in the great School of
Medicine in Leeds, who had set an admirable example for
many years past of truth and candour and straightforward¬
ness in the witness-box, and he was happy to see that their
example was being followed by the younger members of the
profession. When a man really tried to tell the truth, the
" hole truth, and nothing but the truth, in plain and simple
language, notwithstanding what consequences might be
drawn from it, and whether he was called on the one side
or the other, bullying in court and things of that kind ceased
at once. Alluding to Mr. C. G. Wheelhouse, surgeon, of
Leeds, w ho had seen the plaintiff on behalf of the company,
his lordship said that although there was another eminent
gentleman present to give evidence, the defendants had not
found it necessary to call him. He hoped that such a state
of things might long continue in Leeds, and be imitated in
other towns.

The satisfactory state of affairs thus secured may
be contrasted with the unfortunate divergence of
medical opinion in the trial of Dr. William Palmer
of Rugeley, in 1856, in which the Crown had fifteen
witnesses of high professional eminence, and the medi¬
cal witnesses for the defence, among whom was
Mr. Thomas Nunneley, afterwards surgeon to Leeds
Infirmary (1864-69), made rather a sorry display.
Allbutt, in company with two other witnesses in a
railway case tried at Leeds, his colleague C. G. Wheel-
house and Dr. Hall of Sheffield, had written letters
dated August 17, 1872, to the Lancet expostulating
with the statement made in its pages that the di¬
vergence of medical opinion in this ease was a real
scandal to the medical profession.

On June 8, 1880, he was elected a Fellow of the
Royal Society, being the first physician to the Leeds

SIR CLIFFORD ALLBUTT

81

Infirmary to win this honour, though on the surgical
side William Hey, senior (1736-1819), and T. Pridgin
Teale, senior (1801-67) and junior (1831-1923), the
latter Allbutt’s lifelong friend and a high authority
on sanitation, heating, and ventilation, had the envi¬
able letters F.R.S. after their names. Allbutt served
on the Council for two periods, 1896-98 and 1914-16,
when he was also Vice-President. He took an active
part in the work of the Society, serving on the Glass-
workers’ Cataract Committee and on the Tropical
Diseases Committee when it was supervising the long
series of investigations into malaria, Malta fever, and
sleeping sickness.

1881

In 1881 the Allbutts moved from Lyddon House
to Carr Manor, Meanwood, about five miles from
Leeds Station, Allbutt of course retaining his con¬
sulting rooms in Park Square as before. Carr Manor,
which they had been building for some two years,
was a fine house with remarkably handsome iron
gates, hand-wrought, and of Italian workmanship.
It was afterwards occupied again by the outstanding
medical man in Yorkshire, Lord Moynihan, elected
President of the Royal College of Surgeons of Eng¬
land in 1926, who described himself as “a physician
doomed to the practice of surgery”. Miss Marianne
Allbutt often stayed for long periods at Carr Manor,
and Allbutt spoke of the quartet composed of his
wife, his adopted daughter, his sister, and himself
as “our family square”. The Allbutts did much in
the way of genial hospitality generally, and especi¬
ally in giving hospital residents tennis, tea, and
dinner, and the benefit of fresh air and change of

G

1880

82 SIR CLIFFORD ALLBUTT

1881 scene. T. S. Kennedy, his companion on many climb¬
ing holidays, was a near neighbour, and, as already
mentioned, had a remarkably fine organ which was
constructed in 1869—70 and was one of the last and
chief monuments of Edmund Schulze’s incompar¬
able art. It was lodged in a picturesque “tabernacle”,
a building in chalet style, large enough to seat some
eight hundred people; it was planned to have an
opening, and that Samuel Sebastian Wesley (1810-
18^6) should do this; “but, no, the master would not
come — he could not, or would not, show off before
a party of guests. After some negotiation, Wesley
made the hard terms that he would come on con¬
dition that no one should be present save Schulze,
Mr. and Mrs. Kennedy, and myself (Allbutt). So the
master came; appearing and disappearing like a
wraith, but a wraith under a radiant halo of illumina¬
tion. He lifted us up in an organ glory which none
of us had known before, or since. For, almost as he
sat down, Wesley pulled out every stop he could sec,
and himself lifted up in the glorious noise, for nearly
two hours took a long flight of improvisation, mostly
in counterpoint and on big combinations. Then he
descended to earth, or nearer to it, and strayed de¬
lightfully among the several stops. Finally, he turned
to Bach, playing the preludes and fugues by the old
tradition and giving out the first subject on the great
diapasons and rather slowly throughout. It was a
wonderful afternoon, for Wesley himself (as he
fully admitted) as well as for us.”1 In the last years
of his life Allbutt became somewhat deaf and con¬
versation presented some difficulties, but fortunatelv
his power of hearing music remained unimpaired.

1 Allbutt, The Organ , London, 1925, v. 82.

SIR CLIFFORD ALLBUTT

83

For the session of 1880-81 Allbutt was President 1881
of the Leeds and West Riding Medico-Chirurgical
Society, in which he had long been and continued
to be active. When some twelve years later (Session
1892-93) the Society decided to create an order of
Honorary Life Members the first recipients were
Allbutt, Crichton-Browne, and Wheelhouse. In
August the Sixth International Congress in Medicine,
attended by more than three thousand medical men,
was held in London under the presidency of Sir
James Paget, and Allbutt read a paper in the Medi¬
cal Section, presided over by Sir William W. Gull,
on “The Treatment of Scrofulous Glands” as being
then a borderland and neglected subject between
medicine and surgery. On October 19 he delivered
the inaugural address at the Midland Medical Society
at the Grand Hotel, Birmingham, on “Surgical Aids
to Medicine”,1 in which he expressed the conviction,
on which he afterwards insisted, especially in his
address at St. Louis in 1904, that physic and surgery
should not be separated. His remark, “It has been
too hastily said that specialism has been the bane
of modern medicine”, may seem commonplace now,
but at that time it required some courage to stand
up against the general disapproval in high places of
specialties.

1882

On June 27 he took the oath as a magistrate for
the West Riding of Yorkshire. From a record found
among his papers it appears that, in connection with
a case of typhoid fever seen during this year in con¬
sultation, he anticipated, but never published, the
1 Brit. Med. Journ., 1882, i. 1.

84 SIR CLIFFORD ALLBUTT

1882 spread of the disease by a human “carrier”. In August
1882 the British Medical Association celebrated its
Jubilee, and accordingly met at Worcester, its birth¬
place. Allbutt was President of the Section of Medi¬
cine, and his former teacher and future colleague at
Cambridge, Sir George Murray Humphry, presided
over the Section of Anatomy and Physiology. They
both gave presidential addresses. Allbutt, speaking
on “Modern Freedom of Thought and its Influence
on the Progress of Medicine”1, referred to the import¬
ance of comparative pathology, thus following on
similar lines the argument in Sir James Paget’s
address, as President of the Section of Pathology at
the Cambridge Meeting of the British Medical Asso¬
ciation in 1880, on “Elemental Pathology”,2 which
dealt with the diseases of plants.

1883

As already mentioned (vide p. 74), he was elected
a Fellow of the Royal College of Physicians of London
in April of this year at the same time as Osier and
Julius Dreschfeld of Manchester. As one of the four
junior Fellows he was subsequently appointed Goul-
stonian Lecturer for the following year, and though
extremely busy in consulting practice his spare time
must have been much occupied in the preparation of
the three lectures always given under this Trust. The
honorarium, then £10, has recently been rightly in¬
creased by a grant from the Sadlicr Trust to twenty-
five guineas. In July he recorded a case described
as lying upon the confines both of migraine and

1 Brit. Med. Journ., 1882, ii. 2G1.

2 Ibid., 1880, ii. (ill, 6-19.

85

SIR CLIFFORD ALLBUTT

epilepsy, with attacks in which consciousness, the 1883
senses, speech, and writing were impaired.1 In his
comments on the ease he refreshingly brought in an
illustration of his experience as a climber: “Speech
being the highest psychomotor function would thus
first feel the failure of general brain power, and dex¬
terity would be the next in order to suffer. For in¬
stance, an English alpine climber towards the end
of an arduous excursion will find the language he
speaks worst to vanish from him. If this be German,
he may still retain some conversational power in
French; but finally this will soon also leave him, and
he will be reduced to his mother tongue. Even this
fled from Professor Tyndall on one occasion when,
after a grievous climb, he found on entering the
Grimsel that he was incapable of articulate speech.”

Being President of the Medical School for the
second time, he again delivered the Introductory
Address at the beginning of the winter session, the
previous occasion being in 1871 ( vide p. 54). Taking
as his title “Medical Study and Practice”,2 he dealt
eloquently and faithfully with the virtues and fail¬
ings of the profession, dwelling on some points of
medical ethics and giving hints how to avoid the
misunderstandings that may arise between medical
practitioners; thus, he advised those who felt ag¬
grieved at the actions of their colleagues to avoid “the
wretched habit of writing letters” in preference to a
heart-to-heart talk, and deprecated the use of the un¬
fortunate phrase “medical etiquette”, which leads the
public to suppose that the profession has peculiar
rules which no ordinary man can understand. The

1 Brain, London, 1883-84, vi. 246.

2 Bril. Med. Journ., 1883, ii. 661.

86

SIR CLIFFORD ALLBUTT

1883 matter, manner, and broad-minded charity and wis¬
dom of this address recall those — “Aequanimitas”
(1889) and “Unity, Peace, and Concord” (1905) —
subsequently given by his future colleague, the late
Sir William Osier. The Social Science Congress met
at Huddersfield early in October, and at a combined
meeting of the Educational and Health Sections on
October 4 there was a discussion on the important
question, “Is the modern System of Education exert¬
ing any deleterious influence upon the Health of the
Country?” To this Allbutt contributed a paper en¬
titled “The Influence of Modern Education”, thus
recalling his paper on “Brain Forcing” earlier in the
year. The Board School system he regarded as fairly
satisfactory, and the accusation of overwork levelled
against the elementary schools as exaggerated, but
“the great blot on the system was the pupil teacher,
who should be utterly abolished”.

During this year a number of the clinical cases
under his care in the Leeds Infirmary — of sanguine¬
ous abdominal cyst, of acute pericarditis with effusion
and recovery after paracentesis, and of chorea —
were published in the Lancet by his house-physician,
J. F. W. Silk, afterwards a well-known anaesthetist
in London.

1884

Allblitt’s Goulstonian Lectures before the Royal
College of Physicians of London in March 1884,
originally entitled “Chapters on Visceral Neuroses”,
were published in book form, Visceral Neuroses :
Neuralgia of the Stomach and Allied Disorders, by
Messrs. J. & A. Churchill, and served a very useful
purpose in calling a halt to the vagaries of the gynae-

SIR CLIFFORD ALLBUTT

87

cologists, then attaching exaggerated importance to
uterine displacements. These lectures, embodying
much experience of neurotic patients with wide read¬
ing and a broad view of medical practice, created
a sensation, and indeed, as Sir James Goodhart told
Sir Clifford, stimulated him to give his successful
Harveian Lectures on “Common Neuroses” (1891).
Allbutt, wielding a rod of ridicule, satirized the erring
gynaecologists, the plight of whose patient he de¬
scribed as follows: “She is entangled in the net of the
gynaecologist, who finds her uterus, like her nose, a
little on one side, or again like that organ is running
a little, or it is as flabby as her biceps, so that the un¬
happy viscus is impaled on a stem, or perched on a
prop, or is painted with carbolic acid every week in
the year except during the long vacation when the
gynaecologist is grouse shooting, or salmon catching,
or leading the fashion in the Upper Engadine”. He
graphically pictured such a patient’s mind “thus
fastened to a more or less nasty mystery, it becomes
newly apprehensive and physically introspective and
the morbid chains are riveted more strongly than
ever. Arraign the uterus and you fix in the woman
the arrow of hypochondria, it may be for ever.” It
would have been somewhat surprising had the gynae¬
cologists meekly sat down under this chastisement
and said nothing in reply; at the Cardiff meeting of
the British Medical Association in the following year
the Section of Obstetrical Medicine arranged a dis¬
cussion on “The Local and Constitutional Treatment
of Uterine Disease”, to be opened by its President,
the late W. S. Playfair (1835-1903), Professor of
Obstetrics at King’s College, London, who was to
lead the counter-attack. Allbutt was given notice

188

88

SIR CLIFFORD ALLBUTT

1884 of this, and, as he found it impossible to attend the
meeting, Playfair sent him the opening address.
Allbutt 1 naturally wrote a reply, which was duly read
at the meeting; he pointed out that, while his stric¬
tures on the practice of certain gynaecologists had
been duly discussed, no notice was taken of the praise
he had expressed for the services rendered by gynae¬
cology. He gracefully took leave of “a controversy
which has had, at least, this great result — that it
produced so invaluable an apologia from Dr. Play¬
fair’. Ten years later, it may be noted, Playfair and
Allbutt edited the System of Gynaecology (1896).

In 1884 Allbutt, Claudius Galen Wheelhouse, and
T. Pridgin Teale, junior, had completed twenty years
on the full staff of the Infirmary. At the time of their
appointment in 1864 there was not any fixed term of
years’ service, but in the interval a new law limiting
the tenure of office to twenty years on the full staff
or on attaining the age of sixty years, whichever
event came first, had been passed in the face of not
unnatural opposition by those already on the staff;
it may be mentioned that when such a change has
been enacted elsewhere it has, at any rate as a rule,
not been retrospective. In April 1884, therefore, these
three ceased to hold office and became members of
the consulting staff, but remained “members of the
Infirmary Faculty”, with the right to the use of six
beds and to deliver six lectures to the students annu¬
ally, privileges which did not cease even if the mem¬
ber left Leeds or its neighbourhood. The termination
of a physician’s or a surgeon’s time at a big hospital
is usually a severe wrench, as it suddenly removes an
occupation of great opportunities and activity, and

1 Brit. Med. Journ., 1885, ii. 581).

SIR CLIFFORD ALLBUTT

89

further, by being a kind of hint to the world at large
of final retirement from all medical work, cuts into
his practice; this is not an immediate effect, but be¬
comes obvious in a very few years. In Allbutt’s case,
though at the comparatively early age of forty-seven
he felt the break with the habits of twenty years, it
did not make such a great difference, for his stay in
Leeds was only prolonged for five years, and his
practice was now so widespread and extensive that
there must have been considerable physical relief.
For with an enormous consulting practice, the long
distances he had to go, at a time long before motors
were dreamt of, he often was compelled to spend the
night away from home. In the address to the York
Medical Society in October 1892, shortly after he
had settled at Cambridge, he described his feelings
of isolation when he ceased to be physician to the
Infirmary, and expressed his disapproval of the rule
that made it necessary.

Dr. A. G. Barrs, who became resident medical
officer in 1879, and afterwards physician, to the
Leeds Infirmary, writes: “He was the most attractive
clinical teacher I have ever known, and it is not too
much to say that I learnt more from him than from
any other of my teachers. He visited the wards every
Thursday morning from ten to twelve o’clock, and the
whole time was occupied by what I may call a series
of exquisite thumb-nail clinical lectures on the cases
put before him.” Towards the end of the year he pub¬
lished a clinical lecture on scrofulous glands in the
neck,1 a subject he had brought before the Inter¬
national Congress of Medicine in 1881, and no doubt
was now considering again, for a few months later,

1 Med. Times and Gaz., London, 1881, ii. 805.

1884

90 SIR CLIFFORD ALLBUTT

1884 witli his colleague T. Pridgin Teale, he brought out a
short monograph on this subject (1885).

1885

Early in the year he published a clinical lecture
on migraine,1 a subject on which he had already
written twice, and had an inherited interest in, for his
father suffered from it in a typical form, and he him¬
self had attacks of teiehopsia and hemiopia, though
he never had a headache or vomited except at sea.

In collaboration with his lifelong friend and col¬
league T. Pridgin Teale he published a small work
on Scrof ulous Neck and on the Surgery of Scrof ulous
Glands (8vo, London), setting forth the advantages
of the now universally accepted operative treatment
of tuberculous glands in the neck. This represented
their more mature experience since Allbutt’s paper
on the same subject before the International Congress
of Medicine in London in 188], and contained com¬
ments on the artificial boundaries between medicine
and surgery, which were more fully set out in All¬
butt’s address at St. Louis in 1894. In July Allbutt
drew attention to the characters of the delirium in
chronic heart disease, namely, that it was a “delirium
of place”,2 the patient imagining that he was in some
house other than his own; a further and important
prognostic feature of this cardiac delirium was that
the patient never recovered. Though mentioned by
psychiatrists, for example, by Clouston under thetitle
of “cyanotic delirium”, this observation attracted
little general attention; in 1924 R. Massini re-

1 Med. Times and (iaz., London, 1885, i. 203.

2 Provinc. Med. Journ., 1885, iv. 248.

SIR CLIFFORD ALLBUTT

91

described it as “travelling delirium”, and there was 1S85
some correspondence on the subject in the medical
press, in the course of which Professor G. M. Robert¬
son1 of Edinburgh pointed out that the character
described as travelling was common to all forms of
true delirium. In August Allbutt wrote a letter to the
British Medical Journal on “The Relations of the
Medical Profession to Public Morality”2, praising a
leading article in the previous week’s issue on sexual
ignorance. He sternly condemned the conduct of
medical men of eminence who countenanced and
even recommended irregular sexual indulgence to
young men under the erroneous doctrine that it was
necessary for their health. He said: “The secret in¬
fluence of medical men in raising the tone of society,
and especially of men, on the point of sexual honour,
is enormous and incalculable”, and expressed the
hope that “our vigilance may henceforth prove equal
to our opportunities of working for purity, and of
teaching the higher laws of the nature of man”.

1886

This year was exceptional in presenting a com¬
plete interlude in Allbutt’s otherwise consistent liter¬
ary output, and no doubt this was explained by
the heavy calls on his time and of an exceptionally
busy consulting practice.

1887

He was faithful to the Leeds and West Riding
Medico-Chirurgical Society, of which he had been

1 Brit. Med. Journ., 1924, ii. 34, 161.

2 Ibid., 1885, ii. 3G5.

92

SIR CLIFFORD ALLBUTT

1887 President during the session of 1880-81; thus, at one
meeting1 he read notes of cases, such as seven or
eight repeated attacks of coma with slight paralysis
of one side with recovery, ascribed to syphilis, and
at another made a communication with the interest¬
ing title “The last Days of a Case of Graves’ Disease”,
describing dropsy and heart failure two years after
the thyroid symptoms had disappeared. At a previous
meeting on January 14 he discussed the persistence
of paralysis in limited groups of muscles, and also
pernicious anaemia2. Later on in the year he pub¬
lished a paper on simple dilatation of the stomach
or gastrectasis3, a subject in which he had been
interested for nearly twenty years.

In August 1887, John Young Walker MaeAlister
(1856-1925), then Librarian of the Leeds Library,
was appointed resident Librarian of the Royal Medi¬
cal and Cliirurgical Society, in succession to the late
J. B. Bailey, recently elected Librarian to the Royal
College of Surgeons of England. The old Medical and
Cliirurgical Society was then at 53 Berners Street,
London, W., with a list of less than 800 Fellows, and
MaeAlister was largely responsible for its move to
20 Hanover Square in 1890, and for its transforma¬
tion into the Royal Society of Medicine in 1907 and
its removal in 1912 into its new house at 1 Wimpole
Street, W., with a roll of over 4000 Fellows at the
time of his resignation in 1925. When speaking in
reminiscent vein on receiving a testimonial on July
7, 1920, Sir John MaeAlister, as he had been since
the previous year, said that his appointment in 1887
“was largely due to the strong support of my greatly

1 Lancet, 1887, i. 780. 2 Brit. Med. Joum., 1887. i. 214.

3 Med. Press and Circ., London, 1887, N.S., xliv. 81 (J.

93

SIR CLIFFORD ALLBUTT

loved and revered old friend Sir Clifford Allbntt, 1887
then of Leeds.”

1888

In 1888, when the British Medical Association
met at Glasgow, under the presidency of the late
Professor Sir W. T. Gairdner (1824-1907), Allbutt
received the honorary LL.D. degree and delivered
the Address in Medicine, a custom which has been
abandoned since 1914, on the “Classification of Dis¬
eases by Means of Comparative Nosology”1. At this
important meeting he took the opportunity of plead¬
ing for the broader conception to be obtained by the
study of comparative medicine and pathology, and
dealt with the science of the history and geography
of disease, a subject at that time somewhat neglected
in this country. The careful investigation of the
diseases of animals was advocated in order to throw
light on those of man. To this theme he often re¬
turned, and after many years he had in 1923 the
gratification of seeing established in Cambridge an
Institute for Research in the Pathology of Animal
Diseases and the appointment of J. B. Buxton as
Professor of Animal Pathology. He was also appropri¬
ately elected as the first President of the Section of
Comparative Medicine of the Royal Society of Medi¬
cine for the year 1923-24.

From the opening paragraphs of his Glasgow
address the following may be quoted: “Of late years
my associations have prevented an attachment to
that kind of special investigation to which my earlier
years were devoted; I have, therefore, none of the
results of experiment to lay before you”. . . . “In one

1 Brit. Med. Journ., 1888, ii. 284.

94 SIR CLIFFORD ALLBUTT

1888 large conception of Medicine my mind has dwelt for
many years, and I gladly seize this time to place it
before you, for I believe it to be the Novum Organon
of Medicine, its instrument, and a clew to its investi¬
gation. I ask your permission to make a few reflec¬
tions on the classification of diseases by means of
Comparative Nosology — a method which will co¬
ordinate the ever-increasing accumulations of our
clinical note-books and of our laboratories and create
a system which, in its turn, will direct and inspire
the labours of the inductive inquirer of the future.”
He quoted from his paper on “The Significance of
Skin Diseases in the Classification of Disease” in the
St. George's Hospital Reports (1867, ii. 187), and
from his address when President of the Section of
Medicine at the British Medical Association Meeting
at Worcester in 1882, when he pointed out that there
could not be any complete therapeutics until the
science of comparative nosology is in great measure
constructed — a science as yet scarcely begun, nay, as
yet scarcely recognized.

That summer, when holiday-making in Switzer¬
land, he was on his arrival at Schaffhausen eagerly
greeted by Sir James Paget (1814-99), who was in
great distress on account of the sudden dangerous
illness of one of his party, and had gone to watch
the new arrivals at the hotel “with the faint hope
that an English doctor might be among them; and
there was Dr. Clifford Allbutt — I could not, in all
England, have desired to see any other man more”.1

1 Memoirs and Letters of Sir James Paget, p. 375, 1901.

COMMISSIONER IN LUNACY
1889

In 1889 the British Medical Association met for the 1889
second time in Leeds, and when the arrangements
for the appointment were under consideration, All¬
butt’s name naturally came up for the presidency,
but he gracefully waived his claims in favour of
those of his colleague C. G. Wheelhouse. As matters
turned out, he had left Leeds by the time the meet¬
ing took place, and was unable to attend; but, as
will be seen directly, he had occasion to refer critic¬
ally to his friend’s Presidential Address, and entered
into a correspondence with him on the subject in the
pages of the medical press.

In April 1889 Allbutt, rather suddenly as it seemed
to the world at large, and indeed to all except his
most intimate friends, accepted a Commissionership
in Lunacy, and left Leeds for London. In reality this
was only the realization of an opportunity of escaping
from a life of strain that had for some time been too
strenuous. The accumulated demands of a consult¬
ing practice, extending from the Trent to the Tees,
numerous official responsibilities and other duties,
although his physiciancy to the Leeds Infirmary
came to an end in 1884 and he wisely always took
six weeks’ holiday in Switzerland, were beginning

95

I

96 SIR CLIFFORD ALLBUTT

1S89 to exact their toll. Indeed, an eminent London phy¬
sician warned him that a breakdown would follow
within six months if he continued to lead his accus¬
tomed life, a verdict which coincided with his own
impression. The history of his appointment as Com¬
missioner may be told in the following account which
Sir James Crichton-Browne has most kindly pro¬
vided: “When lecturing ‘On the Education of the
Hand’ to the Leeds Philosophical and Literary Society
in February 1886, I was Allbutt’s guest, and when
driving out to his house at Meanwood after the
lecture, he said : ‘It is this hill that finishes me off.
I am busy in my rooms in Park Square all the fore¬
noon; consultations at Dewsbury, Halifax, Harrogate,
and so on fill up all the afternoon, and then when I
get back I have this long drive, am generally late for
dinner, and after that don’t feel equal to the work
I should like to do. As you know, I have had tempt¬
ing invitations to go to London, but there I suppose
it would be pretty much the same thing. What I want
is an appointment that would involve less fatigue
and give more leisure.’ ‘I quite sympathize with you,’
I said, ‘but unfortunately there is no public medical
appointment in this country that is worthy of your
acceptance. You are making a very large income, and
the salary attached to the best public medical appoint¬
ments, those of the Lord Chancellor’s Visitors in
Lunacy and of the Chief Medical Officer of the Local
Government Board, does not exceed £1500 a year.’
‘That,’ he replied, ‘would satisfy me. I have some
private means and have saved something, and I
should accept one of those appointments were it
offered to me.’ I pointed out to him as forcibly as I
could the somewhat crippling nature of such appoint-

SIR CLIFFORD ALLBUTT

97

ments from a medical and scientific point of view,
and the fact that they all meant arduous work,
although of a different character from that in which
he was then engaged. But he adhered to his wish to
secure such an appointment, and I promised to let
him know when there was likely to be a vacancy in
any of them.

“In March 1889 I ascertained that Dr. Rhys
Williams, one of the Commissioners in Lunacy, who
was in bad health, was about to resign and told All¬
butt so, and when that resignation almost immedi¬
ately took place Allbutt’s application was sent in.
There were many eligible candidates, but Lord Hals-
bury had no hesitation in selecting Allbutt. His
qualifications as a physician were pre-eminent, and
he had some special lunacy experience in the work
he had done at the West Riding Asylum in my time,
and as one of the Committee of Visitors of that
Institution, which he had afterwards become. All¬
butt was appointed a Commissioner on April 25,
1889, and held that office until April 1892, when he
was appointed Regius Professor of Physic in the
University of Cambridge. On his resignation of the
Commissionership, a resolution was passed by the
Board expressing regret at the loss of his services and
the appreciation and regard in which he was held.”

His colleagues as legal Commissioners were Mr.
C. P. Phillips, Mr. (afterwards Sir) Charles S. Bagot,
and Mr. W. H. Frere, who were all members when he
was appointed, and remained on after he resigned, the
two latter being most frequently his colleagues in
visiting the mental hospitals. The telegram announ¬
cing the appointment was handed to him on his way
down from a climb on Helvellyn, in the English Lakes,

H

1889

98

SIR CLIFFORD ALLBUTT

1889 and thus cut short his holiday, as he at once went
to London. This was the end of his long and busy
career in Leeds.

With regard to his professional income in Leeds,
the difference between the value of money forty and
fifty years ago and now must be borne in mind. He
told a colleague of his that he had once made over
£6000 in a year, and that after he was fairly started
he generally made between £4000 and £5000 a year.
A house physician of his during the height of Allbutt’s
popularity recalls the somewhat grim joke in medical
circles that “no good Yorkshireman would rest
quietly in his grave if, before his death, he had not
been seen by Clifford Allbutt”.

A colleague of Allbutt’s at the Leeds Infirmary
writes: “The three outstanding physicians of the
nineteenth century in Leeds and Yorkshire were un¬
doubtedly Hobson, Charles Chadwick, and Clifford
Allbutt”, who were physicians to the Leeds General
Infirmary from 1832-42, 1842-71, and 1864-84,
respectively. “They all prided themselves on their
horseflesh and their turn-outs. Dr. Hobson either
kept or bred thoroughbred horses; Charles Chadwick
always had four horses standing in his stable, and
sometimes five or six; Allbutt was always very well
turned out, and, as far as I remember, always almost
drove a pair, and usually roans.”

When Commissioner in Lunacy he became con¬
vinced on logical grounds that general paralysis of
the insane is due to syphilis; at the time he expressed
this opinion freely in conversation, and even men¬
tioned the subject when speaking at a medical dinner,
but it is not to be found anywhere in print. He argued
that it was generally regarded as a disease of cities,

SIR CLIFFORD ALLBUTT

99

but that there was little general paralysis in some in¬
land mental hospitals, whereas there was much at the
Royal Naval Asylum at Great Yarmouth, and sailors
are not men of cities. If, therefore, it is a disease of
cities, the question arises what infection is likely
to cause it, and his answer was syphilis. This was
considerably before the syphilitic origin of general
paralysis was accepted. In after years he several
times recalled this anticipation of a present-day
commonplace to his friends. That his interest in psy¬
chological medicine was maintained to the end of his
life was shown in many ways; for example, by his
part in establishing the Diploma in Psychological
Medicine at Cambridge in 1912, by his vigorously
expressed disapproval of psycho-analysis in the
Presidential Address at the Cambridge meeting of
the British Medical Association in 1920, and also by
the following letter in 1923 to the late Sir Frederick
Mott:

You asked me if I had read your Psychology and Medi¬
cine } I have just done so, and with the greatest pleasure.
It is a comfort to find we have some pillars who uphold the
physiological (and pathological) study of mind stripped of
medieval entology. . . . Your hope concerning waning of
syphilis is comforting. . . . Science has her own limited field,
which is not philosophy nor literature. . . . P. 7 — Freud and
Jung: We have heard all our lives of the contemplative and
the practical man; what is gained by the very pedantic
terms “introverts and extraverts”? And the secret springs
of character have been the study for ages of the poets and
others whose insight is infinitely deeper. ... It is grievous
that, while railways are scattering populations, no one makes
for a photographic survey. Many counties have a character¬
istic race, e.g. Sussex, long isolated by forest, etc.; Dorset;

1 Brit. Med. Journ., 1923, i. 103.

1889

100

SIR CLIFFORD ALLBUTT

1889 parts of York; Northumbria; Scottish Border. ... Do not
speak ill of the mystic; all religion rests upon him. Very
curious about the lack of insanity among the persecuted
Serbs. I don’t see why a sane parent should not produce
a defective child if it only falls short of development, an
accident or check, as one might say. As to insanity, I am
“intrigued” by the cases of recurrent insanity, e.g. mania.
These persons are quite normal between whiles. I know
several of them in private life; quite normal persons for
weeks and months until back comes the (poison?). This
means that the machinery remains all right. It looks like some
“wireless” disorder, which ought to be run to ground in
some gland. ... I have had intimation again of the terrible
mischief these men (psycho-analysts) do; even those sup¬
posed to be “trained”: young women with minds poisoned,
family secrets dragged into the light, bitter discussions, and
so on. Calamitous! It is a fashion like “Christian Science”,
etc. We do not realize the harm that is done by talking about
things. Evil things become familiar, and tolerated; e.g.
people read so often about divorce that they get to regard
it as part of customary life. And so for other evils. . . .
“Complex” not very English and not very useful. It does
not convey the notion of systematic build-up. . . . There is
lots more to say, if you survive the avalanche.

After living for two months in a furnished house
at Richmond, the Allbutts settled down in London
at 3 Melbury Road, West Kensington, and no doubt
the artistic atmosphere of the neighbourhood, with
G. F. Watts at Little Holland House, Lord Leighton,
Marcus Stone, Luke Fildes, and others close by, was
congenial. Allbutt had been a member of the
Athenaeum since 1880, and after coming to London
was for a short time a member of the Savile Club
(1891-95), being elected in the same year as Rudyard
Kipling and his friend Mr. Justice Alfred Wills. He
was one of “The Sunday Tramps”, established in

SIR CLIFFORD ALLBUTT 101

1879, who, under the leadership of Leslie Stephen
(1832-1904), their “chief guide”, explored the coun¬
try round London and occasionally dropped in on
their friends, especially George Meredith on Box
Hill, in the country. During the fifteen years of their
existence “The Sunday Tramps” altogether num¬
bered sixty; the other medical members were Robert
Bridges, Charles Creighton, Clinton Dent, Donald
MacAlister, A. T. Myers, and G. H. Savage.1

The summer was naturally much occupied in
completing the move from Leeds, and instead of tak¬
ing his usual holiday of six weeks in Switzerland he
went to Scotland. In October he gave the introduc¬
tory address at St. George’s Hospital, taking as his
subject “The Need for a Liberal Education”;2 he
spoke of a university as “a permanent embodiment
of the ideal of wisdom as opposed to technical furni¬
ture — of the ideal of mental culture as opposed to
the collection of ‘tips’ and devices in memory”. To¬
wards the close of the address he made some shrewd
recommendations about conduct in practice, and
urged men to welcome a consultation and a second
opinion— advice which, having retired from a most
extensive practice, he was exceptionally well placed
to give; he added: “if I had my way, no man, not
even a pauper, should die of acute or obscure disease
without a consultation”. He also criticized the re¬
marks about the old apprenticeship system of medi¬
cal students made in the Presidential Address at the
recent meeting of the British Medical Association at
Leeds by his friend and former colleague Claudius

1 Vide list of “The Sunday Tramps” in Life and Letters of Leslie
Stephen, by F. W. Maitland, p. 500, 190G.

2 Brit. Med. Journ., 1889, ii. 751.

1889

102 SIR CLIFFORD ALLBUTT

1889 Galen Wheelhouse, who was one of the first three
direct representatives elected by the profession of
England on the General Medical Council in 1886. It
so happened that in the October address1 to the Medi¬
cal Department of the Yorkshire College at Leeds
1 rofessor (later Sir) William T. Gairdner, Regius
Professor of Medicine at Glasgow, also dissented from
Wheelhouse s view on this question, and the result
was a correspondence in the British Medical Journal
between these three friendly protagonists in which
others joined, one of the latter reproving Allbutt for
“flippancy” and thus bringing down on his head a
deservedly rather severe rejoinder.

1890

In the early summer he spent a holiday on the
wild coast of Pembrokeshire and wrote an article
entitled “St. Davids” in The Speaker on June 28,
giving a pleasant account of his experiences and
pointing out that the tired worker who wants relaxa¬
tion, and, above all, change, can without crossing
the Channel, and within eight hours of Paddington,
lose himself in a new country, among a new people,
and in a strange language. In fact, that here may be
found things to interest him as deeply as he would
abroad.

The annual meeting of the British Medical Asso¬
ciation was held at Birmingham under the presi¬
dency of Dr. (later Sir) W. F. Wade. On July 31 there
was a discussion in the Section of Psychology on
“Hypnotism in Therapeutics”, opened by the late
Dr. Norman Kerr, the President of the Societv for

1 liril. Med. Journ., 1889, ii. 751.

103

SIR CLIFFORD ALLBUTT

the Study of Inebriety, who urged the medical pro¬
fession to set their face against the practice of hyp¬
notism in any way as unreliable, never free from
danger, and liable to the gravest abuses. At this time
the uses of hypnotism and suggestion, as practised
at Nancy, on much less dramatic and more reason¬
able lines than by Charcot and his school at the
Salpetriere, by Liebault, a general practitioner, H.
Bernheim, physician to the hospital, Beaunis, the
Professor of Physiology, and Liegois, a lawyer and
author of the standard work on the medico-legal
aspects of hypnotism, were attracting a good deal of
attention. In a broad-minded and independent
speech Allbutt stood up for the possible therapeutic
use of hypnotism, and pointed out that the opener
had not supplied any proofs of the alleged dangers.
Eventually, after an adjournment of the discussion
to the next day, a committee, under the chairmanship
of Professor W. T. Gairdner, was appointed to in¬
vestigate the true nature of hypnotic phenomena, the
propriety or otherwise of its value in the treatment
of disease. Nine years later Allbutt included in his
System of Medicine (1899, viii. 420-28) an article by
J. Milne Bramwell on “Hypnotism in the Treatment
of Insanity and Allied Disorders”.

1891

In May Allbutt took with him his friend the late
Thomas Hardy to see a large private lunatic asylum;
Hardy, who had intended to stay a quarter of an
hour only, became so interested in the pathos of the
cases that he remained there most of the day, and
talked to many of the male and women patients. In

1890

104

SIR CLIFFORD ALLBUTT

1891 July at the Bournemouth meeting of the British
Medical Association Allbutt read a paper in the
Psychological Section on “The Proposed Hospitals
foi the Insane J in which he brought forward reasons
showing that mental hospitals for more than a
thousand patients were undesirable.

1 Journ. Merit. Sc., 1891, xxxvii. 314.

REGIUS PROFESSORSHIP OF PHYSIC AT

CAMBRIDGE

1892

On January 29 Sir George Paget, who had been 1892
Regius Professor of Physic at Cambridge since the
resignation of Professor H. J. Hales Bond (1801-83)
in 1872, died full of years and honours, having with
Sir George M. Humphry and Sir Michael Foster
(1836-1907) raised the Cambridge School from a
state of dormancy to one of great activity. Five
Regius Professorships — of Divinity, Hebrew, Greek,
Physic, and Civil Law — were founded with a stipend
of £40 per annum each by Henry VIII in 1540. A
sixth Regius Professor — of Modern History — was
instituted in 1724 by George I. Of the five original
Regius chairs there were up to 1900 the following
number of incumbents:1

Divinity 30 with an

average duration of tenure of 12 years.

Hebrew .25 ,,

„ „ 14-5 „

Greek . 30 ,,

„ „ 12

Physic . 18 ,,

„ „ 20

Civil Law 25 ,,

„ 14-5 „

The longer tenure of office by the Professors of Physic
might at the first blush be ascribed to their skill in

1 At Oxford, where five Regius Professorships with similar stipends
were founded in 1546, the incumbents of the Chairs up to 11)00
number as follows: Divinity, 34; Hebrew, 24; Greek, 27; Medicine,
20; Civil Law, 21.

105

106

SIR CLIFFORD ALLBUTT

1892 prolonging their own lives, but though to some
extent this may be true, it is not the whole story.
The shorter duration of the Professors of Divinity,
Hebrew, Greek, and Civil Law would appear to have
been in part due to their translation to some other
higher or more lucrative office, whereas the Regius
Professors of Physic were local physicians and,
with one exception, that of Dr. H. J. H. Bond, who
was Regius from 1851 to 1872, vacated their office
only with their last breath. During the eighteenth
century only three Regius Professors of Physic
were appointed: Christopher Green, appointed in
1700 when forty-nine years of age, held the chair
till his death in 1741, and was succeeded by Russell
Plumptre (1709-93), then thirty-two years of age,
who held it for the record period of fifty-two years,
and on his death in 1793 was followed by Sir Isaac
Pennington (1745-1817), then forty-eight years of
age, who held it for the twenty-four remaining years
of his life. Francis Glisson (1597-1677), the most
distinguished of these Regius Professors of Physic,
occupied the chair for forty -one years, from 1636
until his death in 1677 when eighty years of age. The
shortest tenure of office was that of Ralph Winterton
(1600-36), a most excellent Grecian, who died the
year after his appointment. Regius Professors, like
all Professors appointed after October 1, 1924, now
vacate their office at the end of the academic year in
which they attain the age of sixty-five years.

In 1590, just fifty years after the foundation of
the Regius Professorships, Thomas Forking (1528-
1591), who was Regius Professor of Physic (1564-91),
obtained from Robert Cooke, Clarencieux Iving-of-
Arms, a grant to the five Regius Professors by letters

BOOK-l*I.ATK 01' l'UOFESSOIl Cl.I ITOll 1) AI.I.BIJ'H’.

107

SIR CLIFFORD ALLBUTT

patent, “ and their successors in lyke place and office
for euer,” of arms and crests.1 The description of the
arms and crests of the Regius Professors of Physic
reads as follows:

Arms: azure a fess ermine and three lozenges gold; on a
chief gules a gold leopard charged on the side with the letter
M sable. Crest: on a wreath gold and azure a silver quin-
quangle.

Allbutt had an artistic book-plate ( vide figure)
on which the arms and crest of the Regius Professor
of Physic occupied a prominent position, and habitu¬
ally used them on his writing-paper

The stipend of the Regius Professor of Physic
was increased from the original £40, partly by a
house and premises bequeathed to the University
by John Crane (1572-1652), apothecary and Sheriff
of Cambridgeshire, for the use of the Professor; but
as the site was required for the building of the Senate
House in 1724, they were exchanged for property in
Market Street. At the time of Allbutt’s appointment
the stipend was £700, subject to a deduction of £200
if the Professor held a college headship or fellowship,
and was met from the trust fund and ancient stipend
and the balance from the University Chest. Under
the Grace of October 31, 1919, the property held for
the Trust was sold and the proceeds invested by
the Ministry of Agriculture and Fisheries. For three
years the stipend was then in excess of £1200 per
annum; but since 1923 it has been £1200, at which
sum it was definitely fixed in June 1926.

Of the six Regius Professors, three, those of Civil
Law, Physic, and Modern History, are appointed by

1 Vide Historical Register of the University of Cambridge, by J. R.

Tanner, p. 71, 1917.

1892

108

SIR CLIFFORD ALLBUTT

1892 the Crown, the other three being elected by Boards
of Electors constituted as in the case of most other
professorships.

Very shortly after Paget’s death the late Sir
Andrew Clark (1826-93), then President of both the
Royal College of Physicians of London and of the
Royal Medical and Chirurgical Society, which in
1907 expanded into the Royal Society of Medicine,
was sounded on behalf of some members of the
Medical Faculty by the late Dr. Alex Hill, Master
of Downing from 1888 to 1907. But, though talking
it over for two hours, while some thirty patients
waited for their morning appointments, and then
expressing how much he would enjoy an office which
would give him the leisure to record his experiences
and observations, and “break the net” in which
his London work had entangled him, Sir Andrew,
after further consideration, decided that he would
not entertain the invitation. The post was then
offered to Allbutt, who before he left Leeds was
believed to have been not unwilling to consider the
similar appointment at Oxford, should it have been
offered to him. In fact, it has been said that had
Sir Henry Acland (1815-1900) been certain that he
could secure Allbutt’s election as his successor he
would gladly have retired considerably sooner than
he actually did in 1894. This question, however, was,
as far as those then in Oxford now recollect, never
ventilated or discussed, and probably remained in
Acland’s and Allbutt’s minds. But in 1892 the circum¬
stances had changed, and Allbutt, now settled in
London and enjoying the new life with its freedom
after the strain of his enormous consulting practice,
and with the attraction of new and intellectual

SIR CLIFFORD ALLBUTT

109

society, was somewhat disinclined to embark on a 1892
new career. In his address at York in the following
October he described this London interlude as an
enjoyable “holiday of a new vocation and a new
studentship”. Eventually he was persuaded by the
late Sir William Broadbent, on behalf of Her
Majesty’s advisers, to reconsider his decision, and
his appointment was accordingly notified to the
University by the Prime Minister, Lord Salisbury,
in a letter, now in the Registry of the University,
dated February 21.

In March he was elected a Fellow of his old
College — Gonville and Caius— being the seventh out
of the eighteen Regius Professors of Physic to be
a member of that Society. His selection was the
first departure from the custom of appointing a
physician on the spot, and as the Lancet's annotation
(1892, i. 481), while applauding the appointment,
said, “it must have come on many as a surprise, for
even ‘the calm and serene’ air of Cambridge may
have been slightly ruffled by the news, where more
than one physician may have had hopes in connec¬
tion with the vacancy”. Though, therefore, arousing
some disappointed opposition, it was a most wise
choice, probably largely due to Sir Michael Foster.

Sir William Osier’s translation from Baltimore to the
sister university in 1904-5, a similar break with pro¬
cedure and a much more striking introduction of new
blood, was attended by similar success. These two
men added to the academic status of a university
professorship the experience, reputation, and author¬
ity gained in the wider medical world in which they
continued to play an active part. Like his one-time
colleague, Sir Henry Acland, Regius Professor of

110

SIR CLIFFORD ALLBUTT

1892 Medicine at Oxford from 1858 to 1894, Allbutt had
a refreshingly wide and far-seeing conception of medi¬
cine, rapidly picking out the essentials, and more
concerned with general principles than with details.
They both realized the fundamental importance of
a sound general education, deprecated the cry
“specialize early”, and on the grounds of insufficient
clinical material, were opposed to the establishment
of complete medical schools at the two older uni¬
versities. Allbutt was anxious to link up the various
parts of the curriculum, and to illustrate normal by
disordered function; for example, by showing cases
of dropsy to students in the course of their physio¬
logical, bio-chemical, and pharmacological work. They
both had most keenly at heart the establishment of
the science of comparative pathology; in a letter1
dated July 24, 1891, Acland wrote from Oxford: “At
last I can see the hope of the foundation here of a
general comparative pathology, one of my lifelong
dreams for Oxford, through good report and evil
report. You must all help me to counteract the
craze here to educate numbers only for the ‘M.B.’,
omitting thereby all earlier conception of the wider
morphology and pathology which John Hunter, one
would have thought, had founded for ever.” In his
address at the annual meeting of the British Medical
Association at Worcester in 1882 and at Glasgow in
1888 Allbutt had pleaded vigorously for the same
ideal.

The appointment of a Regius Professor of Physic
who was not previously a resident and already a

1 Quoted by F. II. Garrison, Contributions to Medical and Bio¬
logical Research , dedicated to Sir William Osier in honour of his
Seventieth Birthday , 1919, ii. 718.

Ill

SIR CLIFFORD ALLBUTT

physician to Addenbrooke’s Hospital was followed 1892
by a state of affairs which, to say the least of it, was
most anomalous and unfortunate. For eight years
Allbutt was without a status in the hospital, and
therefore was like a professor, say of physiology, with¬
out a laboratory. The Minutes of the lay Board of
Addenbrooke’s Hospital show that on October 5,
1892, a small committee was appointed to confer
with the medical staff with a view of associating the
Regius Professor with the work of the hospital; on
October 24 the conference reported that no means of
associating Professor Allbutt could be recommended,
and there the matter remained. It was not until
1900, Dr. P. W. Latham having vacated his position
as physician in 1899, that this condition, which All¬
butt had borne with the greatest forbearance, was
rectified as the result of an arrangement between the
University and Addenbrooke’s Hospital. Grace 3 of
March 15, 1900, confirming a Report of the Council
of the Senate, provided that —

There shall be paid to the Treasurer of the Hospital out
of the University Chest, the yearly sum of £300, such pay¬
ment to continue so long as the provisions hereinafter con¬
tained on the part of the Governors are observed, namely:

(i.) That the Governors, on the application in writing of the
Vice-Chancellor, elect the Regius Professor of Physic to be a
Physician, and the Professor of Surgery, if any, to be a Surgeon
of the Hospital; such respective Professor to hold office during
the tenure of his Professorship.

(ii.) That the Governors, on the application in writing of
such Physician or Surgeon respectively, assign to him a pro¬
portionate share of the beds in his department corresponding to
the number of Physicians or Surgeons in such respective depart¬
ment.

(iii.) That if cither of the said Professors shall not desire

112 SIR CLIFFORD ALLBUTT

1892 to have charge of beds, all proper and reasonable facilities be
afforded to him for lecturing either in the Wards or in the Board
Room as may be desirable.

(iv.) That all proper facilities be provided at the Hospital for
conducting the University Examinations in Clinical Medicine
and Clinical Surgery, any expenses incurred in the conduct of
such Examinations being paid by the University as heretofore.

Neither of the said Professors shall receive any share of
the fees paid by the Students.

It was therefore fortunate that these eight years
(1892-99) were extremely busy with the editing of
the System of Medicine and visits to Greece (1894),
to the Twelfth International Medical Congress at
Moscow (1897), and to America to give the Lane Lec¬
tures at San Francisco (1898), when Allbutt extended
his journey to Japan. Further, during this period he
took, as will be seen, a prominent part in University
affairs, and in all respects proved that the Professor¬
ship is in no way, as has sometimes been suggested,
“a retiring billet”.

In May he delivered an inaugural lecture at Cam¬
bridge on “Standards and Methods in Medical Teach¬
ing”.1 After quoting the dictum of a colleague that
“a physician should be a kind of poet”, he added:
this is “a hard saying, for to their patients what are
the most scientific physicians if they be 8un>oVTircol
Trvev/ia fir) exovres, if they know all things save the
human heart. ‘On ne connait jamais parfaitement
que celui que Ton devine.’ ” He gave much wise and
critical advice in discussing the value of the tradi¬
tion of the University to which he had returned after
fighting amidst “the roaring of the great loom of the
labouring and sweating world without”. Ilis message

1 liril. Med. Joum., 1892, i. 1005.

SIR CLIFFORD ALLBUTT

113

ran : “Had not Oxford and Cambridge of late years
revolutionized their methods both in positive science
and philosophy, even their great traditions would
not have saved them from decay. Neither for medi¬
cine, then, nor for other callings, are the universities
primarily professional schools. Any opportunities for
gaining professional knowledge here are adventitious,
and might even become means of danger did we not
always bear in mind that the chief function of a uni¬
versity which is true to her trust must be to promote
a harmonious development of all the faculties of man,
knowing that the rest will follow in due season. In
this trust let us exhort ourselves to stand fast.”
Elsewhere in this address he spoke of classical educa¬
tion: “It is sad to hear it commonly said that the
day of learned physicians is past, that they are gone
with periwigs and bric-a-brac. And I have had already
to observe to my pain that the Cambridge medical
student of to-day is by no means ‘learned’; that too
often he thinks loosely, and that he does not always
write even the English of the gentlemen who do the
Fires and the Murders for country journals. On his
Latinity I will discreetly keep silence.” After, and
largely as a result of this lecture, the question of intro¬
ducing an essay into the tripos examinations in order
to improve the facility of writing English was dis¬
cussed at length, the situation being described, with a
certain poetic licence, in the pages of the Cambridge
Review (1894-95, xvi. 159):

There’s an awful row in Cambridge, and its starter is no lesser
Than a most important person, who is likewise a Professor;

For he said, “The reason Cambridge fails, while Oxford’s a
success, is

Essays.”

I

1892

114

SIR CLIFFORD ALLBUTT

1892 If we only were like Oxford, we might safely hope to win
Situations on some journals which as yet won’t let us in;

And the key that will unlock for us the portal to the Press is

Essays.

So memorialists by dozens drew a letter up to state
“Our facility in English is at best inadequate;

And the cure we would assure you for our obvious distress is

Essays”.

Ihen the Special Boards are summoned to discuss the situation;
They admit we are a failure without any hesitation;

“There’s one only panacea”— every Special Board confesses,

“Essays”.

So hurrah! for the Professor who has shown us our sterility,

For we soon shall be possessors of an adequate facility,

1 01 we le adding to the number of our pre-existing messes

Essays.

Settling down in Cambridge, they for some six
months occupied a house, 17 Brookside, opposite the
Leys School, and then moved permanently into a
larger house in quieter surroundings and with a fine
garden, St. Radegunds, Chaucer Road. During the
long vacation he gave a course of lectures in his room
in the Medical School “On Fevers and Infectious
Diseases”, which were correlated with the work done
in the pathological course. In July he attended the
meeting of the British Medical Association at Not¬
tingham, and took part in the discussion introduced
by the late Sir William H. Broadbent on the cardiac
tonics in the Section of Pharmacology and Thera¬
peutics. It is a privilege of his official position to give
addresses, and he responded nobly and without delay
to these calls for the next thirty years. On October
12 he gave the inaugural address1 at the York Medi¬
cal Society, and as the audience was not entirclv

J

1 Lancet, 1892, ii. 1149-52.

115

SIR CLIFFORD ALLBUTT

medical, he discussed the relations that exist, and 1892
should exist, between medical men and society at
large, the place and function which the profession has
in the body of the State. Thus he reviewed some of
the difficult problems that medical men have to face,
such as the prolongation of life when it is a painful
agony from mortal disease, the care of the mentally
defective, and the prevention of suicide. With regard
to eugenics and the survival of the fittest, he said:

“We cannot tell which shall be the fittest till the form
of the coming time is revealed. A society at one time
may need bone and muscle, at another time may
dispense with some of its prize-fighters and need the
qualities of the inner life. . . . Tenderness, gratitude,
love, are more to us than two legs, two arms, or two
lungs; moreover, the higher gifts of the imagination
may be found in the frailest or the humblest vessels.
What would have been our loss had the parents of
Keats or the Lambs been forbidden to marry by the
common order of medical men to forbid the unions
which may produce such children?” He pleaded for
a broad sympathy and acquaintance with humanity,
for medical men have not only to minister to bodily
ills in the grosser sense but to disorders of the mind
and the imagination; he repeated what he had more
than once publicly said: that titles and the honours
of the market-place are rather for others; and that the
calling of medicine, as Darenberg said, had “some¬
thing religious, something solemn and sacred”, which
ill accords with controversy and domination. In con¬
clusion, he referred to the then burning question of
vivisection, and in pleading for the acquisition of
more knowledge, quoted Sir William Gull’s dictum:
“Nothing, madam, is so mischievous as ignorance”.

1892

H6 SIR CLIFFORD ALLBUTT

In 1892 his article on “Diseases of the Pleura” in
Quain’s Dictionary of Medicine was revised for the
second edition with the help of Professor T. Wardrop
Griffith, with whom he corresponded on the subject.
Thus he wrote when near Scarborough on August 24
1892:

My dear Griffith— Will you kindly do this: (1) Read
over my article carefully with a pencil and note freely and
plainly any matter, word, sentence, paragraph, grammar,
sense or construction which seem to you in the least question¬
able. And let me have your notes. On my part I promise that
I will not give any more weight to them than you desire me
to do. I am too old a hand to have any literary vanity or to
forget the advantage of a “fresh eye” on one’s MS. (2) Will
you give me references to any new views or practice, good
or bad, which should be noticed. After our final removal to
Cambridge next month I shall have plenty of time to work
the article up. . . .

THE SYSTEM OF MEDICINE
1893

The System of Medicine, edited by Sir John Russell
Reynolds (1828-96), in five volumes, which came out
between 1866 and 1879, had by this time become
somewhat out of date, and accordingly the publishing
firm of Macmillans approached Allbutt to edit a new
System of Medicine. With a mind that always ran on
big lines he began to plan what was probably his
greatest literary service to medicine, and in deter¬
mining the scope of this laborious undertaking he in¬
sisted on broad principles. Advice was sought freely
from others, and during its early stages, especially
from Alfred Antunes Kanthack (1863-98), who for
some years acted as deputy for C. S. Roy (1854-97),
the first Professor of Pathology, before succeeding to
this chair, which to the great loss of medical science
he occupied for little more than a year; Virchow,
under whom he had worked, said of him, “May Eng¬
lish medicine never lack such men”. In December
1893 preparations for the work were actively begun,
and a circular explaining the scope of the work and
asking those whom he wished to be contributors to
let him know on what subjects they would be pre¬
pared to write articles. A feature of the System was
the prolegomena, or articles dealing with general

117

1893

118

SIR CLIFFORD ALLBUTT

principles, especially those occupying the first half
of the first volume, of which J. G. Adami’s article, or
rather monograph, on inflammation, F. W. Mott’s
general pathology of nutrition, Burdon-Sanderson’s
doctrine of fever, and Kanthack’s general pathology
of infection stand out. In his philosophic introduction
he dealt with science and practice, with etiology, and
with the classification and nomenclature of disease in
a manner which made many regret its omission from
the second edition. In commenting on the absence at
the present day of the philosophical outlook on medi¬
cine and the distinctions between words, thoughts,
and things, Dr. F. G. Crookshank1 wrote: “It is per¬
haps a sign of the times that the admirable essay
contributed by Sir Clifford Allbutt to the first edition
of his System of Medicine in 1896, in which were dis¬
cussed, in inimitable style, such topics as diagnosis,
diseases, causes, types, nomenclature, and termino¬
logy, should have disappeared from subsequent
issues. This essay is now seldom mentioned: perhaps
it is even less frequently read. But, to the present
writer, in 1896 a raw diplomat, it came as something
of a revelation for which he has ever since been
humbly grateful.” No less than fourteen other
articles appeared under his name, the chief being
those on diseases of the heart and stomach, and on
neurasthenia and chlorosis; but his wide range of
knowledge was shown by those on other and very
different subjects, such as adiposis dolorosa, opium
and other forms of poisoning, senile paraplegia, tuber¬
culous glands in the neck, and mountain sickness, on
which he could write with the authority of an alpine
climber and personal experience. With his wide read-

1 Med. Press and Circ., London, 1923, clxvi. 502.

119

SIR CLIFFORD ALLBUTT

ing he did much in supplementing the contributors’ 1893
articles, and with his high standard of composition
and the correct use of words he took the editing very
seriously, and did much in altering and sometimes
even in largely rewriting articles. His methodical
habits and business-like promptitude in answering
letters by return of post were in no small degree re¬
sponsible for the success of The System. An editor has
necessarily many trials and experiences; the appear¬
ance of the second volume was delayed by the tardi¬
ness of the Vaccination Commission, which sat from
November 1888 to April 1896, in bringing out its
report, and in the preface to the fifth volume he ex¬
plained the delay in the delivery of Professor W. H.
Welch’s classical articles on thrombosis and embol¬
ism; this doyen of the Johns Hopkins University,
Baltimore, where he was Professor of Pathology from
1884 to 1916, Director of the School of Hygiene and
Public Health from 1916 to 1927, and Professor of
Medical History from 1927, was then committed to
a desperate fight for the freedom of physiological re¬
search in the United States of North America, and so
unable to fulfil his engagement in due time; with his
light touch the Editor went on: “He is unkind enough
to add that ‘all this trouble comes from England,
where, if your scientific men had made any sort of
courageous stand twenty years ago I should not have
been sacrificing my time and energies in this way. I
am disposed to think that the trouble I have caused
you is a judgment for the delinquencies of your coun¬
trymen in this matter.’ ” After some further remarks
on the difficulties of his contributor, Allbutt wrote:
“This story I have ventured to tell at some length
because it contains an interest and perhaps a warning

120

SIR CLIFFORD ALLBUTT

1893 for us all”. The concluding paragraph in this preface
runs as follows: “Dr. Mackintosh of Clapham has
sent to me the list of errata in the third volume, which
is pi inted upon another page of this one; for this kind¬
ness I trust that in a sincere and chastened spirit I
am duly thankful to him”. A glance at these sixteen
corrections shows that, except “for left read right”,
and for former read latter” , they are not very serious;
but there was a curious misprint, in a later volume,
which throws a light on the way we read proofs, and
these were read by several eyes, namely, “ cozvtail
nervous system”. One of the contributors, the late
Dr. Samuel Gee (1839—1911), a most meticulous
writer of condensed English, stipulated that if he con¬
tributed an article, as he did, on pleurisy, it should
not be editorially altered. Another contributor, now
also long dead, sent in an article written partly on
scraps ol paper, such as the backs of envelopes, as if
composed at any odd moments and on train journeys;
knowing him well, Allbutt inquired why, as under¬
stood between them, it had not been typewritten; the
author then confessed that he had sent it to a typist
who, however, could not make anything out of it.
The only thing to be done was to send it straight off
as it was to the printers, and hope for the best; for¬
tunately they made a good job of what turned out to
be a most valuable article. Originally planned to be,
like Russell Reynolds’ System, in five volumes, it
eventually extended to eight, the first coming out in
189G and last in 1899. In addition, he edited as a com¬
panion volume A System of Gynaecology (1896) with
the late W. S. Playfair (1835-1903), Physician for
Diseases of Women and Children at King’s College
Hospital, who introduced with much enthusiasm and

SIR CLIFFORD ALLBUTT 121

success Weir Mitchell’s rest-cure treatment into this 1893
country. In 1906 a second edition of this System of
Gynaecology by Many Writers (pp. 949), edited in con¬
junction with T. W. Eden, Obstetric Physician to
Charing Cross Hospital, appeared. The System of
Medicine was a very remarkable achievement in the
face of inherent difficulties and delays, and indeed
was carried through in a relatively shorter time than
the second edition of eleven volumes (1905-11), for
the management of which he was not entirely re¬
sponsible. It was gracefully dedicated to Sir John
Russell Reynolds, and was at once recognized as
triumphantly representing medicine at its high-
water mark. Osier, then in Baltimore, was anxious
to mark this immediate success by a congratulatory
dinner, but, perhaps because this was at the time of
the South African War, this generous tribute never
took form. In the second edition he revised and in
great measure rewrote his articles, some of them being
much expanded; for example, “Mechanical Strain of
the Heart” in the first edition, which occupied fifteen
pages, appeared as “Overstress of the Heart” in the
second edition, and, including the late R. W.
Michell’s account of the cardio-vascular phenomena
in athletic undergraduates at Cambridge, ran to sixty
pages. In addition, he contributed to the first volume
an account of ancient medicine, which was combined
with J. F. Payne’s summary of “Medicine in Modern
Europe” in a new article on “The History of Medi¬
cine”.

The other events in this year show that he was
active at Cambridge and in the outside world of medi¬
cine. On May 17, at the annual meeting of the Cam¬
bridge Antiquarian Society, to which he had been

122 SIR CLIFFORD ALLBUTT

1893 elected on May 2, 1892, he read a paper on “The
Trade in Amber in Ancient Times”, a subject that
had long interested him. The paper, which was not
published, was discussed by the late Professor T.
McKenny Hughes, who said that the date at which
the trade in amber began was full of difficulties, and
that the amber found at Girton was associated with
bronze of Roman and Saxon age, and therefore had
not any connection with the Bronze Age. Professor
W. W. Skeat made some interesting remarks on the
etymology of the word amber, which was of Arabic
origin, and the Master of Corpus (E. H. Perowne)
showed some beautiful specimens of amber.

At the annual meeting of the British Medical
Association at Newcastle-on-Tyne he opened a dis¬
cussion on the treatment of enlarged cervical glands
in the Section of Diseases of Children, presided over
by Sir Thomas Barlow, being followed by his co¬
pioneer in the surgical removal of tuberculous glands
— T. Pridgin Teale. In the same section he took an
active part in the debate, introduced by Frederic
Taylor, on abdominal tuberculosis in childhood and
its treatment; his main point was that, as a rule,
tuberculosis is a local process. Rather later in the
year a letter previously written to Sir A. Mayo Rob¬
son was published1 in connection with the subject of
peritoneal adhesions as a cause of visceral disability;
it recorded the case of a man with long-continued
gastralgia necessitating constant administration of
morphine, the cause of which was found at the
necropsy to be a band running between the stomach
and the abdominal wall.

On the sudden death from angina pectoris on

1 Brit. Med. Journ., 1893, ii. 1407.

SIR CLIFFORD ALLBUTT 123

August 16 of J. M. Charcot (1825-93), whom he had 1893
known from his post-graduate days in Paris, he wrote
an extremely interesting appreciation; 1 he compared
him with Trousseau (1801-67), whose “nature, if not
more ardent, was more eager and effusive. Charcot,
no less ardent, hungered and thirsted for knowledge
with a more covert fire, and showed the intensity of
it rather in his incessant labour and keenness of
observation than in disputation or in formal exposi¬
tion, admirable expositor as he was. Charcot’s in¬
difference, the breadth and equalness of his com¬
prehension, had a quality almost Olympian, and one
could read in that wide brow and powerful face a
staidness which preserved him from oscillations of
opinion, and from the infection of fashions. Undis¬
turbed by remonstrance or ridicule, unshaken by
the giddy agitation of the mesmerists, heedless of
the flatteries of the gossips, Charcot steadily pursued
his investigations in hysteria and other neuroses as
if the Salpetriere and himself were in Saturn.” The
following story was given as characteristic: “One
morning Charcot called for me at my hotel in a
brougham and pair of horses which, even to an
English eye, were flawless. We drove to the Salpe¬
triere, and had been in the wards but a short time
when a scared porter entered, bearing in his arms
books and papers tattered and torn, a fractured
stethoscope, a battered umbrella or two, and the
like debris. We learned that the horses, finding, no
doubt, a court of that hospital very dull, had taken
to scampering around it, forgetting to allow for the
carriage or even for themselves. Charcot inquired
anxiously for the coachman, for he was bon gargon,

1 Brit. Med. Journ., 1893, ii. 490.

124 SIR CLIFFORD ALLBUTT

189.3 and on hearing that he was safe, proceeded imper¬
turbably with a demonstration of some cases of
Meniere’s disease.”

On October 2 he revisited Leeds to deliver the
opening address of the winter session in connection
with the Medical Department of the Yorkshire
College, of which he had been a Governor since its
foundation in 1874, and during that period had made
donations amounting to £455. In this address he
referred to its approaching absorption by the Vic¬
toria University, and laid stress on the duty of uni¬
versities to give a liberal education. This was the
third time he opened the winter session at Leeds,
the two previous introductory addresses being in
1871 and 1883, when he was President of the Medical
School. As it was nearly thirty years since he first
became connected with the School he naturally was
reminiscent and praised famous men: thus while
speaking of the surgical eminence of the Heys and
the Teales he said that Dr. Charles Chadwick “was
the first physician whose scientific attainments and
force of character made a great place for modern
medicine in this county”.

1894

As already mentioned, lie had many artistic lean¬
ings and was early attracted to music. Under the
heading of “Music, Rhythm, and Muscle”,1 he wrote
a letter on February 8 pointing out that the history
of Greek dancing illustrated the close relation be¬
tween muscular movement and rhythm, and indeed
lent force to the argument that music had its origin

1 Nature, London, 1893-91, xlix. 340.

125

SIR CLIFFORD ALLBUTT

in muscular movement. On March 1 the Allbutts 1894
and Miss Margaret England left England, stopping
at Avignon on the way to Marseilles, where they took
a boat to Athens. Allbutt was an ordinary member
of the Hellenic Society, and from 1891-92 to 1895-96
was on the Managing Committee of the British School
at Athens, which at that time shouldered a heavy
responsibility; his presence on this comparatively
small committee was of signal service as showing
that the humanities appealed to men eminent in
other directions. In 1895 there was a meeting in St.
James’s Palace with the Prince of Wales in the chair,
and in the same year, in answer to a monster petition,
a Government grant of £500 a year was secured.
After this Allbutt retired. On their way back from
the meeting at Athens the Allbutts stopped at
Smyrna, Constantinople, Buda-Pest, Vienna, Nurem¬
berg, and Ratisbon.

At a meeting of the Eastern Counties Branch of
the British Medical Association at Yarmouth in June
he brought forward for the first time his conception
that angina pectoris is due to disease of the first part
of the aorta, and not of the coronary arteries or
myocardium. This was an entirely original view on
his part, and it was not until May 1908, when reading
in Sir William Osier’s library at Oxford, that he
found that seventy-one years previously Dominic
Corrigan1 had stated that “inflammation of the
lining membrane of the mouth of the aorta is capable
of producing the group of symptoms to which we
give the name of angina pectoris”. It is rather re¬
markable that in the autumn of this same year
Allbutt wrote his first paper (read to the Hunterian

1 Dublin Journ. Med. Sc., 1837, xii. 243.

126 SIR CLIFFORD ALLBUTT

1894 Society on February 27, 1895) on hyperpiesia, or, as
lie first termed it, senile plethora; this condition of
unduly high blood-pressure not due to renal disease
or arteriosclerosis is now generally accepted and,
especially in America, is often called essential hyper¬
tension. These two conceptions, namely, of the aortic
origin of angina pectoris and of hyperpiesia, are two
outstanding and the best known of Allbutt’s many
contributions in connection with the cardio-vascular
system.

After taking up the position as Regius Professor
at Cambridge he did valuable public service in
steadying and directing lay opinion by letters to
The Times” on subjects on which he was specially
able to speak. One of the earliest occasions on which
he did this was in the autumn of this year. At the
annual meeting of the British Medical Association
at Bristol the Section of Psychology, presided over
by the late Dr. G. F. Blandford, discussed the sub¬
ject of the criminal responsibility of the insane, and
unanimously passed the following resolution: “That
in the opinion of this meeting the present law re¬
lating to the defence of insanity in criminal eases,
as laid down by the judges in 1843, is not in accord
with modern medical science, and should be recon¬
sidered”. This was followed by a leading article two
days later in “The Times” (August 4) and by a some¬
what animated correspondence in its columns in which
G. Pitt-Lewis, C. A. Mercier, who had also expressed
their opinions at the meeting, and others, joined. In
“The Times” of September 1, Allbutt, with the
authority of a late Commissioner, wrote a long letter
whicl i, as a leading article of the same date com¬
mented upon it, he supplemented by a second on

127

SIR CLIFFORD ALLBUTT

September 4. In his first letter he remarked: “No good, 1894
but much harm rather, will result from that girding
of one profession at another of which we have seen
too much in recent correspondence. Pedantry is not
confined to the Profession of Medicine. Nay, in its
greater dependence on authority, the Profession of
Law may be said to be even more open to that
error.”

On December 19 he published a post-graduate
clinical demonstration1 given in London and dealing
first with a man nominally 59 years old, but as a
matter of fact, a very old man of 75 or 80, for “in
Medicine Ave do not count the ages of people by
the revolutions of the earth around the sun, but we
measure them by the revolutions of their own morbid
processes”. In connection with this patient suffering
from cardio-arterial disease, he went on: “It is the
commonest thing in the world for young people to
come to us with some anxiety, saying that they have
pain in the region of the heart, but in ninety-nine
cases out of one hundred it is of no serious import;
but when a man in later life, suffering from cardio-
arterial degeneration, complains of pain in the prae-
cordial region, we must look at it quite differently”.
Some cases of nervous diseases were then shown, and
in connection with one of tabes dorsalis he pointed
out that this was a better name than locomotor
ataxia, which was a symptom common to other
diseases; and that for brevity he often called the.
absence of knee-jerk “knee-stop”, and the Argyll
Robertson pupil “light-stop”. While stating that
syphilis is a very common cause, he considered that
this was not true in perhaps ten per cent of the cases.

1 Clin. Journ., London, 1893-94, v. 117.

128

SIR CLIFFORD ALLBUTT

1894 He reviewed1 three volumes of Rudolf Robert’s
Historical Studies in the Classical Review, and for
the rest of his life, as will be seen, frequently con¬
tributed to its pages notices of new editions of classical
works, especially those of Hippocrates and Galen,
and of critical studies on them, usually by German
authorities. Many of these articles were of the nature
of essay-reviews, thus recalling his work for the
British and Foreign Medico-Chirurgical Review in the
’sixties and early ’seventies of the last century.

1895

The System of Medicine was now actively under
way, but in spite of its demands on his time he was
ever active in other directions. On February 27
he gave a Hunterian Lecture before the Hunterian
Society of London on the subject of “Senile Plethora,
or High Arterial Pressure in Elderly Persons”, al¬
ready referred to, which afterwards much expanded
has, under the name of hyperpiesia, been definitely
associated with his name. In this address, based on
material collected between 1870 and 1889, he sug¬
gested the name hyperpiesia instead of senile plethora,
because the condition is not necessarily one of senility.
In this year the Cambridge Medical Society, con¬
sisting of men practising in and around the town
and to be distinguished from the undergraduates’
Medical Society, started after the War, in which he
was also active, elected Allbutt as their President,
an office which he filled with great regularity for two
years. This Society was started in 1880, and his pre¬
decessor, Sir George Paget, was naturally the first

1 Classical Ilcv., London, 1894, viii. 309.

129

SIR CLIFFORD ALLBUTT

President. To the lay press he contributed a popular 1895
article on “Nervous Diseases and Modern Life,”1
which must have been much in his mind as allied to
his articles on neuroses of the stomach, functional
disease of the heart, and neurasthenia in forthcoming
volumes of his System. On March 5 he went abroad
with his wife, Miss Margaret England, and Miss
Lucy Lockwood, the daughter of their friend Sir
Frank Lockwood, then Solicitor-General, and passing
through the Riviera to Rome, visited many cities in
Italy, such as Pisa, Assisi, Florence, and Bologna,
where picture galleries gave his artistic leanings much
satisfaction, before returning to Cambridge and the
summer time. A summer course for medical post¬
graduates at Cambridge occupied his attention, and
for this purpose the science laboratories were made
available, a plan which, with the assistance of the
late Professor Sir Michael Foster, was successfully
repeated in 1899. The British Medical Association
met in London under the presidency of Sir J. Russell
Reynolds, President of the Royal College of Phy¬
sicians of London, and Allbutt joined in the discus¬
sion, introduced by Dr. (later Sir) Richard Douglas
Powell in the Section of Medicine on “Acute Lobar or
Croupous Pneumonia, its Etiology, Pathology, and
Treatment”.

1896

The burning question of degrees for women was
agitating Oxford and Cambridge at this time. On
February 17, four memorials in favour of this con¬
cession came before the Senate at Cambridge; one
was signed by 2088 members of the Senate, another

1 Contemporary Rev., 1895, lxvii. 210-31.

K

130 SIR CLIFFORD ALLBUTT

1*96 by 1172 students of Newnham and Girton, a third
by 164 head-mistresses of endowed and preparatory
schools for girls, and the fourth consisted of signa¬
tures collected by the late Miss Emily Davies. There
was considerable discussion in the first place whether
or not the question should be submitted to a syndi¬
cate for a report; in this Allbutt joined, and was
erroneously quoted as saying that if women were
admitted as members of the University, their number
in ten years’ time would amount to a thousand. The
appointment of a syndicate nominated in March and
containing the names of Michael Foster and Allbutt
was non-placeted; but on June 4 a syndicate with a
different personnel was approved; this syndicate re¬
ported on March 1 of the following year, and recom¬
mended that the University should confer by diploma
the title of the degrees of B.A., M.A., Sc.D., and
Litt.D. on women who have passed a final tripos
examination and kept nine terms. This gave rise to
a long-drawn-out discussion, which occupies many
pages of the Reporter, and extended over several
days (March 13, 15, and 16). Allbutt, quoting his
experience of the Victoria University, which at that
time included the Yorkshire College at Leeds, said
that he was opposed to a mixed University. This was
followed by a fly-sheet warfare, in which he took
part, both collectively in opposing the recommenda¬
tions of the syndicate, and personally in defending
the accuracy of his statements about the position of
women in the Victoria University, which had been
vigorously challenged by the late R. D. Roberts.
Eventually the recommendations of the syndicate
were rejected on May 21, 1897. This controversial
problem of the relation of women students to the

131

SIR CLIFFORD ALLBUTT

University was again much debated in 1920 and 1896
1921; Allbutt then signed a memorial in favour of
a compromise between the two sides, but eventu¬
ally, on October 20, 1921, the compromise proposal
to admit women to limited membership of the Uni¬
versity was defeated, and it was agreed that women
should have titular degrees conferred by diploma,
but should be excluded from membership of the
University.

The question of examinations in pharmacology
was actively debated in the medical press as a result
of the decision of the Royal College of Physicians of
London to drop this subject from the final examina¬
tion in medicine of the Conjoint Examining Board
of England and Wales. In April, Allbutt, together
with Professor J. B. Bradbury and Dr. (later Sir)
Donald MacAlister, wrote a long letter expostulating
with this decision, and stating that “there was not
any present probability that the University of Cam¬
bridge would wander into this error”. This corre¬
spondence,1 which Allbutt carried on without his
colleagues, continued until the editorial closure
stepped in. It may be mentioned that pharmacology
with pathology are still included in the final examina¬
tion in medicine for the Cambridge M.B. In June,
together with Sir George Humphry, Michael Foster,
Donald MacAlister, and others interested in the
scientific teaching of the University, he appealed to
the Senate to purchase two extensive building sites.

On November 21, in a discussion in the Senate House,
he drew attention to the bad state of the building1
in which the School of Medicine and the Patho¬
logical Museum were lodged, and on December 7,

1 Bril. Med. Journ., 1896, i. 1120, 1236, 1534.

132

SIR CLIFFORD ALLBUTT

1896 in a fly-sheet gave the further information that the
greater part of the building was infested with dry
rot.

On October 5 he read before the Hackney Branch
of the British Medical Association a paper on album¬
inuria in pregnancy,1 which created a good deal of
interest, as is shown by an article entitled “Some
Thoughts suggested by Dr. Allbutt’s paper upon
Albuminuria and Pregnancy” by the late Dr. Lovell
Drage,2 and was much in advance of its time, as the
following letter, written more than twenty years
later by the late Dr. Amand Routh, under the date
of February 15, 1918, goes to prove:

Dear Sir Clifford — Reading your address now for the
first time I am surprised that in 1897 you were able to do
so much towards proving that toxins were present often in
the blood of gravid women and were often the causes of
kidney mischief and of eclampsia. Your remark that “the
placenta probably also has some protective functions” is
(in 1897) prophetic in a remarkable manner, as is the dictum
that “persistent vomiting in pregnancy is evidence of a cir¬
culating toxin and is not of nervous origin”. . . . Your view
as to the need of ending pregnancy in toxic cases is fully
confirmed to-day by our knowledge that after expulsion or
even death of the child, chorionic ferments and their deriva¬
tives cease to be generated. That the brewing of an anti-
substance in a pregnant woman in a first pregnancy helps
to safeguard her in subsequent ones, is another valuable
suggestion made by you, which I think is now fully con¬
firmed, as partly explaining the reduced tendency to
toxaemia in subsequent pregnancies. What a pity your paper
was not better known to obstetricians. ... If you had been
an obstetric physician wc should know much more about
pregnancy toxaemias than we now do.

1 Lancet, 1897, i. 579.

2 Ibid., 1897, i. 875.

133

SIR CLIFFORD ALLBUTT

After Sir George Humphry’s death on September 1896
24 the question of his successor in the chair of surgery
arose and awoke a fly-sheet warfare. The General
Board of Studies recommended that the professor¬
ship should be suspended for a year. At this time
the Regius Professor of Physic had not any right to
utilize the clinical material in Addenbrooke’s Hos¬
pital, and a new Professor of Surgery, unless pre¬
viously on the staff of Addenbrooke s Hospital, would
have been in the same plight. On December 6 a fly¬
sheet signed by Cambridge men who were teacheis
in the Medical Schools of Cambridge and London
respectfully submitted that as “no Professor of
Surgery can be efficient as an authority on Surgery
unless he is on the staff of a hospital and in full
charge of patients, the best interests of medical
study in the University would be furthered by post¬
poning the final appointment of a Professor of Sur¬
gery until such an arrangement has been made as
shall place the Professor on the staff of a hospital
and in full charge of patients”. In the meanwhile a
number of surgeons in London had been approached
as possible candidates or consulted about the posi¬
tion of a Professor of Surgery without beds of his
own, and the almost universal opinion was that such
a position was impossible. Allbutt, who was in this
delicate position and thus able to speak from experi¬
ence, was obliged to take part in the discussion.
Eventually the Professorship of Surgery was sus¬
pended, but was re-established by a Grace of the
Senate on June 11, 1903, when the late Howard
Marsh (1839-1915), consulting surgeon, St. Bartholo¬
mew’s Hospital, was elected. After Marsh’s death
the chair remained vacant until June 4, 1921, when

134

SIR CLIFFORD ALLBUTT

1896 the professorship was discontinued by a Grace con¬
firming a report of the Council of the Senate.

In the autumn he reviewed1 Max Wellmann’s
Die pneumatische Schule, a subject on which he had
much to say in his FitzPatrick Lectures before the
Royal College of Physicians of London in 1910.

1897

On March 22 Allbutt attended a meeting of the
Medical Society of London at which the late Dr.
T. D. Savill read a paper on the pathology and treat¬
ment of senile decay, chiefly based on 409 cases of
death in persons over sixty years of age during the
se\ en years that he had been Medical Superintendent
of the Paddington Infirmary. Stress was laid on high
arterial tension due to hypertrophy of the muscular
coats of the arteries (hypermyotrophy) and inde¬
pendent of kidney disease. Allbutt,2 who could not
agree that long life necessarily causes arterial disease,
described the condition of high arterial blood-press¬
ure in advancing years without kidney disease,
which in 1895 he had called “senile plethora”, or
preferably hypcrpiesia. He accepted the hypertrophy
of the arterial muscular coats, and suggested that
this, as long as atheroma or other degenerative
change did not supervene, protected the cerebral
arteries from the formation of miliary aneurysms,
and thus helped to explain why these patients,
though not uncommonly subject to apoplectiform
attacks, rarely had cerebral haemorrhage. He pro¬
tested against the use of “pulse tension” and “blood

1 Classical llev., London, 1S96, x. 316.

2 Trans. Med. Soe. London, 1897, xx. 273-73.

135

SIR CLIFFORD ALLBUTT

tension”, as the word “tension ’’cannot properly be 1897
applied to the blood or a wave of blood. In a letter1
to the medical press he regretted that Savill’s paper
had not attracted more attention and discussion.

His activities at Cambridge in connection with the
titles of degrees for women during the early part of
this year have been mentioned above ( vide p. 130).

In the summer, Allbutt, as President of the Cam¬
bridgeshire Branch, delivered at the combined
meeting with the East Anglian and South Midland
Branches of the British Medical Association an ad¬
dress on the relative importance of theory and of
practice in the art of medicine.2 In a broad-minded
manner and with much prevision he pleaded for
more communication between the practical man and
the “contemplative” man of abstract speculation,
the experimenter absorbed in his single desire to wrest
from Nature her secrets. He deplored the divorce of
the workers in an art from the thinkers, for practice
advances in efficiency by adopting the new know¬
ledge provided by the man of theory. As in morals,
so in medicine, practical precepts serve for a time,
but must be continually enlarged as our conceptions
widen. Medicine depends upon theoretical advances,
not in physiology only, but in all sciences.

In July he wrote a strong letter to “The Times”
on the needs of Cambridge University, saying: “The
School of Medicine is the largest in numbers in Eng¬
land; yet for the purposes of this faculty a poor
and utterly insufficient building was put up thus
cheaply a hundred years ago”. On August 3, with

1 Lancet, 1897, i. 12.35.

2 Bril. Med. Journ., 1897, ii. 197; ulso in abstract, Nature, 1897,
lvi. 332.

136

SIR CLIFFORD ALLBUTT

1897 his wife and her niece, Miss Margaret England, he
left England to represent Cambridge at the Inter¬
national Congress of Medicine (August 19-26) at
Moscow, where they stayed with Prince Pierre
Galitzm and his daughter. On the way there they
stopped at Bayreuth, and on the return journey saw
Stockholm, Christiania (Oslo), and Amsterdam.

At the end of November he was one of a number
of teachers who, having doubts as to the advisability
of retaining the Additional Subjects of the Previous
Examination, requested the Council of the Senate
to afford an opportunity for discussion of the matter,

whether by the appointment of a Syndicate or other¬
wise.

Four German books dealing with the works of
Hippocrates were reviewed by him in a compre¬
hensive article1 during this year.

1898

The Classical Review for February contained a
review2 by him of J. F. Payne’s Harveian Oration on
Harvey and Galen” given on the previous October
19 at the Royal College of Physicians of London. On
March 4 he addressed the Cambridge Medical Society
on the pathogeny of angina pectoris, a subject on
which he was later in the year to lecture at San Fran¬
cisco. In June, on behalf of the Special Board for
Medicine he appealed for £20,000 to build the present
Medical School in Downing Street, and set a notable
example by subscribing £250. At a meeting of Cam¬
bridge medical graduates held in March in London
most cordial support had been given to the scheme.

1 Classical llcv., London, 1897, xi. 102. * Ibid., 1898, xii. 52-54.

137

SIR CLIFFORD ALLBUTT

On June 29, with his wife and Miss Margaret Eng- 1898
land, he left Cambridge and crossed from Liverpool
to America, as he had accepted the invitation to give
at the Cooper Medical College, San Francisco, the
Lane Lectures, financed by Dr. Levi Cooper Lane,
who also founded the Cooper Medical College, which
in 1910, together with the Levi Cooper Lane Library,
was transferred to Stanford University. On the way
across America they visited Salt Lake City, Denver,
and Colorado Springs. In July the ten Lane Lectures
on the cardio-vascular system were delivered; some of
them were published 1 two years later, and dealt with
cardiac phvsics, diseases of arteries, senile arterial
plethora or hyperpiesia, as he now preferred to call
the condition, and angina pectoris (repeated at a
meeting of the Leamington Medical Society in Nov¬
ember 1899). A lecture given on “Mechanical Strain
of the Heart” was not published, as it had just ap¬
peared in his System of Medicine (1898, v. 841-855).

The material of these lectures was intended to be
expanded into a treatise of cardio-vascular diseases;
those on angina pectoris and arterial diseases were
embodied in his Diseases of the Arteries, including
Angina Pectoris, in two volumes published in 1915.

On July 26 they left San Francisco for an extended
tour, taking this opportunity of visiting Honolulu
and Japan; on the last two days of the nineteen days’
voyage to Yokohama they came into the tail of a
typhoon, but fortunately without any serious trouble.

After spending four weeks in Japan they returned
to the United States to fulfil a number of engage¬
ments; after visiting Chicago and Niagara they

1 Philu. Med. Journ., 1900, v. 212-22, 578-82, 017-31, 859-62,
911-14, 1371-74, 1417-19, 1464-08.

138

SIR CLIFFORD ALLBUTT

1898 reached Toronto on October 8, being looked after by
Judge Featherston Osier, the elder brother of Sir
William, and two days later went on to stay with
J. G. Adami, who since 1892 had been Strathcona
rofessor of Pathology at McGill University, Mon¬
treal, where Allbutt gave a lecture at the University,
and much enjoyed seeing Sir William van Horn’s col¬
lections of Chinese pottery and Japanese tea jars, and
of pictures. Quebec and Boston, Mass., naturally in¬
cluding Harvard University, were other stopping, if
not resting, places in their pilgrimage, and on October
17 they reached Baltimore. Dr. (later Sir William)
Osier was away recuperating from a recent attack of
pneumonia, but they stayed in his house and were
hospitably looked after by Professor W. H. Welch
and others during what must have been a much-
needed freedom from constant travelling.

In his lecture on “Medicine in the Nineteenth
Century”, delivered before the Johns Hopkins Uni¬
versity on October 17, 1898, he begins: “Were we
asked to describe in a phrase the tendency which
distinguishes our age, it might be replied that it is the
study of origins. In the later thirteenth and early
fourteenth century, for example, men’s minds were
fixed for the most part on the validity of dialectic,
were more bent upon securing mental surefootedness
and sharp true weapons of thought than upon the
verification of premises.” Later he points out that
“the study of origins, then, is not only the new
method of modern criticism, of modern history, of
modern anthropology, of our reading of the evolution
of the universe itself from elements which even them¬
selves are falling under the same analytic inquiry,
but the study of origins is leading to a revolution in

139

SIR CLIFFORD ALLBUTT

our conception of therapeutics, as of all these other 1898
studies; a revolution which as yet we have not fully
understood”.

On October 20 he lectured on arterial diseases to
students and medical practitioners at the Medical
Department of the University of Pennsylvania, and
on the following day gave an address on the treat¬
ment of arteriosclerosis at Jefferson Medical College,
Philadelphia. From there the party journeyed to
New York, where they saw Dr. J. S. Billings (1838—
1913), who had just been appointed Director of the
New York Public Library, after having the previous
year retired from the Library of the Surgeon-General
of the United States Army, which, together with its
catalogue and the Index Medicus, he had created.

1899

On January 31 a meeting was held at Devonshire
House under the chairmanship of the Chancellor, the
Duke of Devonshire, to inaugurate the Cambridge
University Association, the object of which was to
assist the University in making further provisions for
its financial needs. The Chancellor spoke first and,
believing that example was better than precept, an¬
nounced that he proposed to contribute £10,000 to
the Endowment Fund of the University. He was fol¬
lowed by the Vice-Chancellor (Dr. Alex Hill), Pro¬
fessor R. C. Jebb, the Master of Trinity (Reverend
H. M. Butler), the Attorney-General (Sir Richard
Webster), Professors Clifford Allbutt and Ewing.
Allbutt concluded his appeal as follows: “I have just
returned from the United States, and I am sure we
have lost three good generations in England. I found

140

SIR CLIFFORD ALLBUTT

1899 those people so quick that the moment they see there
is new knowledge to be made they realize the im¬
portance of making it quickly, and they are ready to
endow it. A professor said: ‘We have only to go up and
down in the street to get any money we want if we
aie able to show them we are going to make new
knowledge’. That is the spirit we want in this country,
and it will, I trust, be fostered by the efforts of this
Association.” As a result of the meeting an Executive
Committee of fourteen Cambridge men, including
Allbutt, was appointed.

At the Comitia Vcvna on February 14 the degree
of M.D. honovis causa, was conferred upon him at
Tiinity College, Dublin, and on the same day he was
made an honorary Fellow of the Royal College of
Physicians of Ireland. On April 22 he was at Liver¬
pool when Lord Lister opened the School of Tropical
Medicine, and on July 1 the honorary degree of D.Sc.
was conferred upon him by the Victoria University
of Manchester. During the first few days of August
he was in Portsmouth, and active at the annual
meeting of the British Medical Association; in the
Section of Medicine he opened a discussion on “The
Prevention and Remedial Treatment of Tubercu¬
losis”,1 and drew particular attention to Birch -
Hirschfeld’s researches on the primary site of tuber¬
culous infection in the lungs as shown by photo¬
graphs of his fusible metal casts of the bronchi; he
had visited Leipzig to make himself thoroughly
acquainted with Birch-Hirschfeld’s work. The debate
was carried on by the late Sir William Broadbent,
the late Sir Richard Douglas Powell, and Professor
(later Sir) William Osier of the Johns Hopkins Hospi-
1 Allbutt, T. C., Brit. Med. Jour d., 1899, ii. 1149.

141

SIR CLIFFORD ALLBUTT

tal. In the Section of Pharmacology and Therapeutics 1899
he discussed the late Sir Lauder Brunton’s paper on
the treatment of headaches, and in the Section of
Pathology spoke in the course of a long debate which
followed the paper by the late Dr. J. W. Washbourn
on “The Pathology of Endocarditis”. In August the
Osiers paid a visit to Cambridge, and stayed with
the Allbutts.

On August 30 Miss Margaret England was married
at St, Michael’s Church, Headingley, near Leeds, by
the vicar, Canon Wood, a great friend of the Allbutts,
to the Reverend Harry Stovell Cronin, B.D. (1866-
1923), Fellow, Dean, and Librarian of Trinity Hall,
who edited the Codex Purpureus Petropolitanus (1899)
and the Rogeri Dymmock Liber (1922, Wycliff Society).

As they lived at Willowbrook in Chaucer Road, just
opposite to St. Radegunds, there was no separation
from those who had so long been her parents in all
but name. Of this marriage there was one son,
Clifford Walter, born in 1900, who on September 6,
1924, married at Barrington, near Cambridge, Mar¬
garet, daughter of the late Colonel Bendyshe, a direct
descendant of Nelson; of their two children, one is a
boy, Richard Clifford, so that the name of the Regius
Professor is perpetuated. After the marriage the All¬
butts spent some time at Whitby. At the beginning
of the winter session he addressed the Medical Society
of University College, London, on the conception of
disease, a favourite topic of his. Having been ap¬
pointed in the summer an Examiner in Medicine for
the Licence by the Royal College of Physicians, he had
to be in London for the quarterly examinations in
October, January, April, and July, each of which
occupied about ten days, and so added considerably

142

SIR CLIFFORD ALLBUTT

1890 to his labours. The usual term of office for examiners
living in London is four years, but country Fellows
of the College often hold office for a shorter time, and
Allbutt did not continue it for more than a year. On
November 14 he took part in the discussion on Dr.
(later Sir) J. Kingston Fowler’s paper on the open-
air treatment of tuberculosis at the Royal Medical
and Chirurgical Society, and drew a distinction be¬
tween fresh air and draughts, a subject on which his
open- window treatment of typhus fever in 1865-66
enabled him to speak as one with the authority of
experience.

At this time the Appointments Board, originally
called the Cambridge Appointments Association, was
started in order to facilitate the employment of
members of the University, after the completion of
their undergraduate course, in the various profes¬
sions and occupations for which their University
training has fitted them. In the initiation of this
undertaking, which has proved so eminently success¬
ful, Allbutt was one of the promoters, and subse¬
quently signed a fly-sheet in answer to one opposing
its support by the University.

In December, on the invitation of Commcndatore
Florio, a wealthy and generous citizen of Palermo,
Allbutt, together with Patrick Manson, Lauder
Brunton, G. A. Gibson, Malcolm Morris, St. Clair
Thomson, Walter B. Foster (afterwards Lord Ilke¬
ston), and others, making up a party of about twenty,
were conducted from Charing Cross first to Rome
to see the work done there on malaria, and then to
Palermo to inspect a sanatorium for the tuberculous
which Commcndatore Florio had erected under the
direction of the physician-in-chief, Professor Cervcllo,

SIR CLIFFORD ALLBUTT 143

of the University of Palermo. In Rome they stayed 1899
for some days, meeting Professors Grassi, Bignami,

Celli, and Bastianelli, and seeing two experimental
farms in the Campagna, one screened against mos¬
quitoes, where there was not any malaria, the other
unprotected and with malaria. At Palermo the sana¬
torium — the Villa Igiea — was a veritable palace, on
the edge of the sea cliffs, conducted on the most
up-to-date principles. Under the title of “An Occa¬
sional Correspondent” Allbutt contributed an ac¬
count of this pleasant as well as instructive visit to
“The Times” on his return in the new year.

1900

During the first half of the year the preparation
of the Harveian Oration must have occupied most
of his time. The South African war, which broke out
in the previous October, made it eminently oppor¬
tune to take steps to increase largely the establish¬
ment of the University Volunteer Battalion, then
limited by regulation to six companies, already
standing at more than their full strength. Accord¬
ingly, together with fourteen heads of Colleges and
three other Regius Professors, Allbutt advocated this
change. On March 12 he issued a fly-sheet standing
up for the financial needs of the Medical School and
protesting against a decision of the Council of the
Senate about the monetary grant made without any
previous consultation with him as the official head
of the Faculty of Medicine, especially as the needs
of the Medical School for proper buildings were so
urgent, as he proceeded to show. In the Cambridge
Appointments Gazette for June 1 lie gave some advice

144 SIR CLIFFORD ALLBUTT

1900 to medical students, pointing out that a University
degree should signify something more than practical
skill. While agreeing that clinical work should be
done elsewhere, in a more populous centre, such as
London, he considered that the teaching of pathology
should be given in Cambridge. The subject of thesis
writing was also touched upon.

To the “A Century’s Retrospect of Medicine”
(1800—1900) in the British Medical Journal he made
a contribution on “Medicine in 1800”, 1 and dwelt
particularly on the work and views of William Cullen
(1712-90), the author of an authoritative text-book
on diagnosis and treatment, as a monument of that
time, and as having dethroned “disease” and set up
the patient , thus distrusting systems and recogniz¬
ing that the only real factor was the individual. He
attended the annual meeting of the British Medical
Association at Ipswich and took part in the discussion
on Influenza as it affects the Nervous System”,
introduced by Dr. Judson Bury of Manchester.

On October 1 he gave the introductory address
at the Middlesex Hospital on “Abstractions and
Facts in Medicine”, and spoke of the far greater
future of medicine as a result of the work to be done
by the young, who must be guided by their teachers
between the extremes of reverence and contempt
for authority and tradition. While tradition must
not be handled with too much respect, there was
room not only for positive knowledge and the scien¬
tific habit of mind, but also for a large collection of
approximate empirical truths or maxims, for a
certain shrewdness and dexterity in the use of such
imperfect means, and for some insight into men and

1 Brit. Med. Journ., 1900. ii. 990.

SIR CLIFFORD ALLBUTT 145

society. He urged the importance of post-graduate
study, and expressed the hope that some hospital
would devote its entire teaching energies to this
object. In conclusion, he urged the establishment of
clinical laboratories in all hospitals, not only those
associated with medical schools, so that such a
laboratory in a county hospital should assist all the
private practitioners in the district. Mere observa¬
tions of disease and morbid anatomy had, he said,
almost reached their limit, and it was important
to turn to the detection of morbid processes in their
earliest stage, so as to arrest them there and then.
On the death of Sir Henry W. Acland on October
16, who as Regius Professor of Medicine at Oxford
(1857-94) had been his corresponding colleague for
two years, he wrote a graceful appreciation,1 based on
thirty years’ acquaintance, setting out his idealism
and charm.

On October 18, St. Luke’s day, he gave the
Harveian Oration at the Royal College of Physicians
of London at the request of the President, the late
Sir William Church (1837-1928), to whom it was
dedicated. This annual Oration was founded by
William Harvey in 1656 with definite directions that
the Orator should commemorate the benefactors,
exhort the Fellows and Members “to search and
study out the secrets of Nature by way of experiment,
and also for the honour of the profession to continue
in mutual love and affection among themselves”.
In addition, the Orators have specially commemor¬
ated Harvey’s great discovery, and as the theme
has been so often dealt with, the task becomes in¬
creasingly difficult every year. In his, the 234th,
1 Brit. Med. Journ., 1900, ii. 1280.

1900

L

146

SIR CLIFFORD ALLBUTT

1900 Oration, Allbutt took as his subject “Science and
Medieval Thought”, for, as he modestly wrote: “On
the philosophy of the Middle Ages, and on its rela¬
tion to the era of positive science of which Harvey
was perhaps the chief pioneer, there lay in a drawer
of my cabinet the confused and occasional notes of
many years . . . and I trust some brief essay thereon
may have a temporary service”. This subject had
indeed occupied his mind since 1863, when his friend
Thomas Marshall of Leeds awoke his interest in the
life and works of Roger Bacon. As in several of his
other addresses, this one contained much more than
could be delivered in the hour, and was published in
expanded form as a book1 with the title given above
after its appearance in an abbreviated form as “The
Physiological Darkness before Harvey’s Time”, in the
medical journals.2 In the course of this polished
discourse, adorned with a number of scholarly foot¬
notes and an appendix on astrology, he touched on
the artificial divorce of surgery from physic, a sub¬
ject which he subsequently treated more fully in his
address on “The Historical Relations of Medicine
and Surgery” at St. Louis in 1904.

1901

At a meeting on January 31 of the British Bal¬
neological and Climatological Society, which was
founded in 1895 and in 1907 became a section of
the Royal Society of Medicine, Allbutt opened a dis-

1 Science and Medieval Thought, Cambridge University Press pp
116,1901.

a lirit. Med. Joam., 1900, ii. 1271; Lancet , 1900, ii. 1179; and
A at are, 1900, Ixii. O.'IO (“Aspects of the Discovery of the Circulation
of the Blood”).

SIR CLIFFORD ALLBUTT 147

cussion on anaemia and its treatment,1 and drew 1901
attention to the then recent work of Dr. J. S. Hal¬
dane and Professor J. Lorrain Smith, showing that
in all anaemias there was an increase in the blood
mass. This was familiar ground to him, as in his
System of Medicine he wrote the article on chlorosis
which has since become such a rare disease.

On June 26 he gave away the prizes at the Medical
School of Charing Cross Hospital, and in the course
of his address mentioned that when a boy he had a
small laboratory in his home in which he performed
experiments on rats to satisfy his curiosity; quoting
Hobbes, he insisted on the stimulating value of this
inquiring mental feature which should not, as was
too often the case, be checked in childhood. In July
he published a paper on the spread of infection by
the urine of men convalescent from typhoid fever,2
a subject of special topical interest on account of the
war in South Africa and the return of troops to this
country. Later in this month the Congress on Tuber¬
culosis met in London, at which Robert Koch made
the startling pronouncement that the human and
the bovine forms of the bacillus of tuberculosis were
absolutely distinct species, and that therefore there
was little or no danger of the transmission of the
infection by milk from cattle to man; on July 27, in
Section II., on the Medical Aspects including Clima¬
tology and Sanatoriums, Allbutt,3 who with Sims
Woodhead represented the University of Cambridge,
opened a discussion on sanatoriums in which Sir
James Fowler, the late Sir Hermann Weber, and
Sir R. Philip took part. He then went on to the

1 Lancet, 1001, i. 479. 2 Bril. Med. Journ., 1901, ii. 7-1.

3 Lancet, 1001, ii. 1255,

148

SIR CLIFFORD ALLBUTT

1901 annual meeting of the British Medical Association
at Cheltenham, where he spoke in two discussions,1
on the late Dr. J. W. Washbourn’s paper, “Patho¬
logical Notes from South Africa”, and on the late
Dr. Richard Caton’s method of arresting endo¬
carditis. In The Speaker he reviewed “The Memoirs
and Letters of Sir James Paget”.

On November 11, at the close of a controversy
in the columns of “The Times” on the subject of
Peat Reek and Harris Tweed” between Sir James
Crichton-Browne and Mr. Winston Churchill and
others, he wrote to Sir James the following note in
a light vein, which shows that he was then laid low
by one of the several accidents that befell him when
bicycling or tricycling up to the end of his life in and
around Cambridge:

If you happen to know one J.C.B. will you tell him in
Joe Gargery’s words “Wot larks!” Every time J.C.B.
seemed to be nailed he got his left straight on his adversary’s
nose! “The Times” is quite flat now the fight is over. Excuse
this — not to be called even a “scrawl”. Cycling near home
a week ago, a passing waggoner switched his whip thong
about the handle-bar of my bicycle, when different velocities
and a good “side” came into play. I write now on my back,
have got over my shaking and bruises, but have a left knee
nearly as big as my head.

In December he contributed a tribute to the
obituary notice2 of Dr. William Dobie (1834-1901)
of Keighley.

1902

In January and February he published two
articles on heart affections; in the first, on hyper-

1 Brit. Med. Joum., 1901, ii. 700, 1051.

2 Ibid., 1901, ii. 177G,

149

SIR CLIFFORD ALLBUTT

trophy and dilatation of the heart,1 he mentioned 1902
that alcoholic dilatation, described by Graham Steell
in 1893, had been recognized in Leeds in the ’seven¬
ties; he wrote the other, on cardiac arrhythmia,2 on
account of the paucity in English text-books of any
discussion about the causation, and because the
opinions, when expressed, did not fully agree with
the conclusions he had arrived at; in fact, for two
or three years he had intended to publish a few facts
and reflections on the subject based on clinical ex¬
perience and interpreted by the results of physio¬
logical research. On February 3 “The Times” printed
a letter from him emphasizing the view, expressed in
a letter in the previous November, that the neglect of
the Army Medical Service by university students was
mainly due to the lack of scientific spirit and method
in the service. At this time the war in South Africa
was drawing to a close and the Minister for War,

Mr. St. J. Brodrick (later the Earl of Midleton), was
engaged on the reorganization of the Royal Army
Medical Corps. Later in the year, with the other
examiners in the Indian Medical Service, he wrote a
letter3 defending the method of examination which
had been criticized in an annotation in the British
Medical Journal.

On May 13 he was at Oxford to deliver before the
University Junior Scientific Society the ninth Robert
Boyle Lecture on “The Rise of the Experimental
Method in Oxford”.4 He showed that Roger Bacon
admittedly owed much to a hermit-like individual,

1 Practitioner, London, 1902, Ixviii. 11-27.

2 Med. Chron., Manchester, 1904, 4 ser., ii. 321-28.

3 Allbutt and others, Brit. Med. Journ., 1902, ii. 1930.

* Published in pamphlet form (pp. 53) by Henry Froude; abstract
in Nature, London, 1902, lxvi. 90-91.

150

SIR CLIFFORD ALLBUTT

1902 Peter Peregrinus, in the thirteenth century, about
whom so little was accurately known that his identity
had been divided among three hypothetical persons,
I eter of Maharecourt, Peter of Maricourt, and Peter
of Mericourt, very probably variations of the name of
the same place. After delving in the Cambridge Uni-
vcisity Libiary, Allbutt had come to the conclusion
that these three Peters were one man, before he learnt
from Charles’ treatise on Roger Bacon that that
author had done likewise in 1861. In Montague
Mui lay s third and last edition of Quain’s Dictionary
of Medicine he revised his long article on diseases of
the pleura (pp. 1268-1286), in which he defended his
earlier advice not to tap pleuritic effusions unless
and until they caused respiratory distress.

In the May term there was considerable discus¬
sion on the question whether or not a candidate in
the second part of the Natural Sciences Tripos should
still be obliged to take a second subject in addition to
that in which he might hope to attain a first-class.
Among the fly-sheets which appeared was one
from Allbutt advising delay and maintenance of the
status quo until a clearer view of the whole position
could be attained. Eventually, however, the change
was made, so that a candidate has to take one sub¬
ject only in the second part of the tripos.

Allbutt was the first to recognize James Mac¬
kenzie’s outstanding work, The Study of the Pulse,
Arterial, Venous and Hepatic, and of the Heart, in
a generous unsigned review,1 remarking that “an
original seer of solid achievements was at work in the
Galilee of Burnley”. They were both keenly interested
in the new cardiology, and thus had animated dis-

1 Brit. Died. Journ., 1902, ii. 250.

151

SIR CLIFFORD ALLBUTT

cussions in the columns of the medical press; for ex- 190-
ample, in 1911 on the existence of cardiac asthma,
Allbutt deprecating the use of the term, Mackenzie
vigorously, as was his wont, asserting the genuine
nature of the asthmatic seizures as quite distinct from
the ordinary dyspnoea of cardiac failure ( vide p. 200).
Later, these two warm friends corresponded in public
on the new cardiology in 1917 (vide p. 226). On
February 17, 1925, after Mackenzie’s death, and only
five days before his own, he wrote, to a friend who
was engaged on an obituary notice of Mackenzie and
had asked for some information: “Mackenzie always
honoured me by saying that by my review in the
British Medical Journal of his book The Study of the
Pulse I ‘had brought him out’. So far as winning the
toss is concerned, this, I suppose, was true. Mackenzie
was a generous soul and never forgot his friends.

On July 1 he wrote a letter to the British Medical
Journal,1 in the columns of which there had been a
correspondence on the treatment of pulmonary tube i -
culosis by intratracheal injections, politely expressing
regret that in an article in the fifth volume of his
System of Medicine (1898) it had been suggested by
one of his contributors that the method employed by
Dr. Colin Campbell was not devoid of risk. At the end
of July he attended the annual meeting of the British
Medical Association at Manchester under the presi¬
dency of the late Mr. Walter Whitehead, and intro¬
duced two discussions; on July 30 he opened one in
the Section of Medicine, the President of which was
his friend the late Professor Julius Dreschfeld, on the
causes, diagnosis, and principles of treatment of dila¬
tation of the stomach,2 a condition in which he had
i Brit. Med. Journ., 1902, ii. 155. 2 Ibid., 1902, ii. 1989.

152

SIR CLIFFORD ALLBUTT

1902 been actively interested since 1869, when he read the
pioneer paper of Professor Adolf Kussmaul, to whose
recent death on May 28 he referred. As previously
mentioned, he read a paper on the subject at the Cork
meeting of the British Medical Association in 1879,
-dor.°te the article on in his System of Medicine

iirii7’ m' 512^' In the ensuing discussion the late Sir
William Broadbent (1835-1907), a former student of

medicine at Owens College, Manchester, and the late
Professor J. H. Musser of Philadelphia took part. On
the following day he read the opening paper at a
discussion in the Section of Psychological Medicine
on the relation of neurasthenia to insanity,1 a subject
on which he was specially qualified to speak as a
former Commissioner in Lunacy, and more recently
as the author of the article on neurasthenia in the
eighth volume of his System in 1899.

On November 6 he delivered an address on tuber¬
culosis2 at Glasgow, in which he advocated sana¬
torium treatment, and especially one for children in
Glasgow. In an interesting manner he dealt with the
reproaches which from the time of Plato to the pre¬
sent day have been thrown at the medical reformer
foi preserving bad stocks and thus counteracting
the benefit of the survival of the fittest — by propa^
gating bad stocks. After glancing at what he called
the Pelagian point of view (after the British monk
Pelagius of the fifth century, who was responsible
for the heresy that original sin did not exist), namely,
that no stocks are primarily bad, he said: “Do not
let us talk of bad stocks till we have done our best
with them; for we may discover that it is rather the

1 Brit. Med. Journ., 1902, ii. 1208.

2 Practitioner, London, 1903, lxx. 145.

SIR CLIFFORD ALLBUTT 153

gardeners than the stocks which are bad”; and con- 1902
eluded: “To lie passive, quoting perverted Darwin¬
ism, till, under evil conditions which we have not
tried to remove, our children have grown stunted
and crooked, and then to grumble about the neglect
of the physician to eliminate the unfit, is inhuman”.

He reviewed1 at some length Max Wellmann’s
Fragments of Greek Physicians, and subsequently
more briefly the second volume of Kuehlewein’s edi¬
tion of Hippocrates’ works, the first volume of which
he had reviewed in 1897.

1903

On January 13 he read a paper on the rise of
blood-pressure in later life2 before the Royal Medical
and Chirurgical Society, and in the introductory
paragraph said: “With the pathology of the dead we j
have made great way; the pathology of the living is
hardly begun”. The latter phrase was subsequently
employed by Sir Berkeley (later Lord) Moynihan3 to
describe the information revealed during surgical
operations. Allbutt then gave his early experience of
taking blood-pressures, and insisted that a raised
blood-pressure is not due to arteriosclerosis; he
divided “so-called arteriosclerosis” into three kinds,
the first common in old people, often hereditary, but
not necessarily or usually associated with high blood-
pressure, which he called “involutionary”, and later
in 1907 “decresent”; the second, or mechanical, due
to persistent high blood-pressure; and the third the

1 Classical Rev., London, 1902, xvi. 220-22, 470.

2 Med.-Chir. Trans., 1903, lxxxvi. 323-40.

3 Brit. Med. Juurn., 1907, ii. 1381.

154 SIR CLIFFORD ALLBUTT

1903 toxic, due to lead, alcohol, or syphilis, usually in
younger persons, in some of whom the blood-pressure
rises, in others not. In picturesque language he then
described the condition he called hyperpiesia, or per¬
sistent high blood-pressure not secondary to kidney
disease, and pleaded for its earlier recognition and
treatment. The interest of the subject excited con¬
siderable correspondence in the pages of the Lancet,
in which Sir Richard Douglas Powell, Sir W. Broad-
bent, and Dr. Harry Campbell took part. Sir Her¬
mann Weber, who had supported his claims for the
Regius Professorship in 1892 by writing to Lord
Salisbury, and he had a private correspondence about
the rise of blood-pressure in later life; on November
21, in the course of a letter discussing the etiology,
Allbutt wrote: “As to remoter causes, I am satisfied
that over-eating and drinking is efficient; but I meet
with not a few persons with rising arterial pressures
in later life, whose habits have been temperate or
even abstemious. I suppose in them inadequacy of
‘katabolism’ (often inherent?) amounts to relative
excess of intake. There must be (not, I think, a mere
superfluity, but) some poison generated; Metehnikoff
would say from the colon. This I scarcely take to;
it does not explain the effects of mere over-eating
( + alcohol usually), nor the cases in which the process
is instituted by mental grief and stress, as I showed
twenty-seven years ago, for the allied but different
process of ‘granular kidney’ (vide p. 68). I have
stood alone for years in proclaiming that in a certain
class of cases rise of arterial pressure is the antecedent,
arterial strain and injury the consequence .” After this
interesting statement of his views he went on to
mention that lie had been invited to represent Eng-

SIR CLIFFORD ALLBUTT 155

lish medicine in the following year at the St. Louis 1903
World’s Fair and Exposition, and proposed to read
a paper on the prevention of apoplexy; as events
turned out, he gave one of the two addresses in the
Section of Internal Medicine on “The Historical
Relations of Medicine and Surgery to the end of the
Sixteenth Century” ( vide p. 166) and delivered the
address on the “Prevention of Apoplexy” at Bristol
in January 1905 ( vide p. 170).

In April he published an essay, previously read
to a small private society in Cambridge (The Eranus),
consisting of representatives of different departments,
who discuss topics arising out of their special sub¬
jects, but of more general interest. This account of
“A Chair of Medicine in the Fifteenth Century”1 at
the University of Pavia, dealing with the life of
Johannes Matheus de Ferrariis de Gradibus, who
held the chair from 1432 to 1472, was one of ten
papers which in the course of twenty-one years he
read before the Society, the others being mainly on
ancient medicine, though the first in 1899 was on
“The Part of the Intellect in the Fine Arts” and the
second in 1901 on “Immunity”.

The Diploma in Tropical Medicine and Hygiene
was established in Cambridge in this year, an
example followed in 1912 by the Royal Colleges of
Physicians and Surgeons in London. The examiners
on the first occasion were Sir Patrick Manson, Sir
Ronald Ross, and Professor G. H. F. Nuttall.

On June 26 Allbutt gave the Cavendish Lecture
at the West London Medico-Chirurgical Society on
“Disease of the Ascending Aorta”,2 and then sug-

1 Med. Citron., Manchester, 1903, 4 ser., v. 1-15.

2 West London Med.-Chir. Journ., 1903, viii. 157-8G.

156 SIR CLIFFORD ALLBUTT

1903 gested that the condition of dilatation of the first
part of the aorta should be called Hodgson’s disease,
after Joseph Hodgson (1788-1869), who described it
in 1815. In his account of the physical signs of chronic
aortitis he pointed out that they only needed to be
looked for, and that “when a chronic aortitis, pursu¬
ing for the greater part a painless course, was broken
by terms of acuter activity, angina pectoris might
come and go with such vicissitude”.

From July 7-11 the Royal Sanitary Institute
held its twenty-first Congress at Bradford, and as
President of Section I, dealing with Sanitary Science
and Preventive Medicine, Allbutt gave an address on
July 9. In it he expanded the arguments, previously
brought forward in his address at Glasgow on tuber¬
culosis, against the view that the activities of medical
men and preventive medicine are antagonistic to the
survival of the fittest. “The Nottingham Evening
Post” of that day came out with a report of the meet¬
ing headed “The Survival of the Fittest: Remarkable
Statement by Professor Allbutt”, and proceeded to
put into his mouth the opposite of what he really said:
“Professor Clifford Allbutt combated the Darwinian
theory of the survival of the fittest, and urged that
the medical profession should cease to mitigate in¬
curable disease, whereby useless lives were pro¬
longed, and the survival of bad stocks promoted”.
This misrepresentation was not so widely taken up as
to create a furore; Allbutt was thus more fortunate
than his colleague Sir William Osier, whose farewell
address at the Johns Hopkins University in 1905,
“The Fixed Period”, was broadcasted in the Press
as advocating that men of sixty should “retire for a
year of contemplation before a peaceful departure

157

SIR CLIFFORD ALLBUTT

by chloroform”, because with a humorous allusion 1903
to his own age (56) he had quoted this from Anthony
Trollope’s novel The Fixed Period. After touching
on the vexed question of birth control, Allbutt in¬
sisted that “elimination of the unfit by disease is
too rough a method of compassing the survival of
the fittest, even if the most vigorous of body be re¬
garded as the salt of society”, and called upon the
Congress “to declare that Public Health would do it
better and more permanently than Public Disease

can do it”. .

About this time he was elected consulting phy¬
sician to the Belgrave Hospital for Children, in which
his friend Clinton Dent, surgeon to St. George’s
Hospital and a past-President (1884-86) of the
Alpine Club, took a fatherly interest. In July he
supplied the introduction to a symposium on gout
in the Practitioner,1 and later in the year recorded a
case of that very rare disease myotonia congenita,2
originally described in 1876 by the Danish physician
Julius Thomsen, a sufferer from it, in whose family
it had existed for five generations.

In the autumn he was engaged in a correspond¬
ence3 in the British Medical Journal with the late
Sir Victor Horsley, who had stated in an address to
the University of Birmingham “that the strenuous
effort of Liverpool to develop its College into a Uni¬
versity was resisted by the University of Cambiidge .
Allbutt answered Horsley’s charge in a very spirited
style: “Sir Victor Horsley proceeds to impute to me
and to Cambridge a motive so base that I feel it a

1 Practitioner, London, 1903, lxxi. 1-5.

2 Brit. Med. Journ., 1903, ii. 83G.

3 Ibid., 1903, ii. 1108, 1308.

158

SIR CLIFFORD ALLBUTT

1903 shame even to have to repel it, namely, that I
opposed the Liverpool Charter on the point that it
W1 comPete with Cambridge in the manufacture of
a state qualification to practise. I am thankful to
say that it has needed the ethical ingenuity of mv
distinguished surgical critic to introduce such a
notion now for the first time into my head.”

In October Sir Michael Foster, who in 1870 had
come into residence as Praelector of Physiology at
Trinity College and in 1883 became the first Pro¬
fessor of Physiology in the University, gave up his
chair. On May 1 a letter, signed by Allbutt and many
others, was sent to the \ ice-Chancellor urging that
in consideration of his services to physiology and to
the University the statutory power of granting him
a pension should be exercised. This application came
befoie the Council of the Senate, who did not agree
to present a Grace to the Senate recommending the
pension. Accordingly the signatories of the letter
got up a Memorial submitting that an extraordinary
Professorship should be offered to him and the con¬
ditions and stipend settled by the General Board of
Studies. This Memorial was violently opposed by
the then Downing Professor of Medicine, Dr. P. W.
Latham, in a fly-sheet, belittling Foster’s services to
the University on the grounds that over fifty per
cent, of the registered medical students at Cam¬
bridge never proceed to the degree of M.B., and that
the number registered as medical students in the
University in 1894 was 138, whereas in October 1903
it was 104.

In December Allbutt took part in the pleasant
function of making a presentation to Lord Bray-
brooke on the occasion of the fiftieth year of his

159

SIR CLIFFORD ALLBUTT

Mastership of Magdalene College and of his golden 1903
wedding. The Mastership of this College, founded in
1542, is in the gift of the holder of the Barony of
Braybrooke, as representing the founder, Thomas,
Baron Audley of Walden (1488-1544). Of the twenty-
nine Masters three have been of the family of the
founder, and two of these, Lord Braybrooke (who
succeeded to the title in 1902 only, so that he did
not appoint himself) and his immediate predecessor,
Hon. George Neville-Grenville, each held the Master¬
ship for fifty years.

1904

In 1904 Messrs. Macmillan, who published most
of his books, brought out his Notes on the Composition
of Scientific Papers , which passed into a second edition
the following year, and into a third in 1923. The
stimulus to provide this guide to the young writer
came from his official duty of reading every year
some sixty or seventy theses for the degree of M.B.,
and about twenty-five for that of M.D. A leaflet pre¬
pared by the publishers pointed out that “The Regius
Professor, who receives no pecuniary profit from this
handbook, prepared it for his candidates for M.B.
and M.D. degrees in order to save his time and theirs
in clerical revision of the theses. He recommends them
therefore to use this, or some other such guide to
English composition.” Cambridge is the only Uni¬
versity which demands a thesis for the M.B. degree,
and does so because one of the functions of a uni¬
versity is to teach students to think, and of this ac¬
complishment the thesis or essay is the chief evidence.
During the keeping of the Act the candidate reads
the thesis, or as much of it as the Regius Professor or

1G0

SIR CLIFFORD ALLBUTT

1904 his deputy shall direct, and is questioned on its con¬
tents; in this way the possibility that it may have
been written for him by a commercial “ghost” is at
any rate diminished, for one of the ghosts wrote to
Sir Clifford and “was good enough to suggest that
this old-fashioned custom might well be abolished”.
Instruction in writing theses does not come within
the scope of systematic lectures or teaching, and their
construction and composition are often open to
criticism. This was especially so with Allbutt, who
laid much stress on good English and the correct use
of words; so much so indeed that he found much of
the time allotted for keeping the Act occupied in deal¬
ing with the faulty style at the expense of the discus¬
sion of the matter of the theses. Accordingly this use¬
ful and in parts amusing handbook was conceived
and supplied a very real want. Along with much
ad\ ice it contained a collection of common errors,
and the author made the demure confession that his
“quotations are given for the most part without ac¬
knowledgement, for obvious reasons”. The informa¬
tion and guidance given, on somewhat the same lines
as the King’s English by the brothers Fowler (LI. W.
and F. G.), may be read with advantage by many
besides those about to write theses. On certain words
Allbutt had very decided views; thus: “Theory and
fact are deplorably abused words. Theory, in its
proper use, signifies the highest form of knowledge”,
being admissible in reference to the Newtonian or
Darwinian theory. “A fact is something which has
occurred; it has no reference whatever to the future,
d o say that on t he 30th of next January Venus will
be in conjunction with Jupiter, is not a fact, but a
prediction or truth. This hard-worked word is often

161

SIR CLIFFORD ALLBUTT

employed for “truth”, “proposition”, “rule”, or 1904
“axiom”. The use of the familiar words “type” and
“typical” were also somewhat severely restricted;
he had indeed more vigorously expressed his opinion
about “that insidiously evil word ‘type’ ” thirty-
seven years before1 by complaining that “its four
letters do more harm than the whole of the Calmuck
language together, which latter is said, on accumu¬
lation of evidence, to be the most abominable lan¬
guage now known to exist”. It was therefore just as
well that those not accurately acquainted with the
approved significance of these words were sometimes
advised by their hospital teachers to avoid the pos¬
sible pitfalls entailed by their appearance in theses.

The pedantry of using the Greek and Latin plurals of
words taken into common use, for example “asyla”
for “asylums”, was pointed out, and in finally antici¬
pating that advice may be expected about the use of
great prose writers as models, he said: “Imitate no
one”, but “read to strengthen and enlarge your ideas,
your understanding, and your language”; he men¬
tioned a number of authors who might be read
with advantage, such as Dryden, Lamb, Goldsmith,
John Morley, George Otto Trevelyan, and of the
scientific and medical fathers — Peter Mere Latham,
Thomas Watson, James Paget, and Michael Foster,
the last of whom is known from other and reli¬
able sources to have laid much store on Milton’s
prose.

It is always interesting to hear how men set about
writing a paper or a book; Allbutt, while admitting
that every writer has his own method of composition,
takes the reader of his Notes on the Composition of

1 St. George's Hosp. Hep., 18G7, ii. 187.

M

162

SIR CLIFFORD ALLBUTT

1904 Scientific Papers into his study and shows him how
le first collects in a labelled drawer or large quarto
envelope material bearing on the chosen subject in
the form of cuttings and abstracts (on slips of paper
of the same size); these memoranda may take some
time to collect, and in the case of this particular book
it, is obvious that it must have taken some years to
accumulate the pearls extracted from theses. The
slips are clipped together according to the sections or
chapters of the intended article or book and then
arranged in their logical sequence, from which the
first draft is made. Usually he found three more drafts
necessary before the manuscript was ready for the
printer. In the second draft redundant words and
repetitions were deleted, necessary changes in the
order of sentences and paragraphs made, and further
expansion of the argument and corresponding modi¬
fications added. In the third draft the composition
was still more critically considered; sentences and
paragraphs recast, made to run logically and convey
one meaning only; and every word, even the definite
article, separately weighed. Before undertaking the
final revision, which should not be done piecemeal in
bits, but cover a considerable stretch so as to get a
large survey of its scope, there should be an interval
of a week or two, so that the mind may unconsciously
meditate on the subject, and the final reading be done
with refreshed attention. Lastly, lie gives the follow¬
ing advice: “Never compose when tired, nor in the
false confidence of tea and late hours. At this hour
the composition seems to be beautiful and spontane¬
ous, but it is fairy gold, and in the colder light of the
morning it turns to ashes.” This certainly sets up a
high standard of hard discipline, and many will find

SIR CLIFFORD ALLBUTT

163

difficulty in obeying the direction not to work late 1904
at night.

With a highly critical taste, he was as careful about
his own writings as he would have others be in the
choice and use of words; he never spared himself, and
his alteration of his articles did not cease with the
delivery of the manuscript, as indeed was abundantly
manifest in the printer’s pulls.

His literary style thus had an easy grace, and
was attractive for its refreshing difference from the
ordinary run of medical writing and on account of
the occasional use of good old words. Just as he was
always well groomed in person, so was he equally
careful in literary expression, and with a fastidious
feeling for words and phrases chose them like an
epicure. He had a fine sense of humour, which he used
with all the more effect as the occasions were not too
frequent. With his broad outlook he saw all sides of
a subject and fully discussed them before summing-
up on debatable questions. The assistance that he
most willingly gave to others is shown by the follow¬
ing extract from a letter written by Dr. P. C. Varrier-
Jones, who was closely associated with him at the
Papworth Village Settlement: “His help in all my
papers was, of course, most valuable. Indeed, I do
not think I should have written anything without
his help. He would add or subtract a word which
made all the difference to the sentence, and by so
doing made the balance perfect and the sense crystal
clear.” Allbutt wrote an attractive and characteristic
hand, and did his own typewriting.

In a letter to “The Times” of February 3, he said
that his opinion, voiced in his previous letters of
November 13, 1901, and February 3, 1902, about the

SIR CLIFFORD ALLBUTT

1904 state of the Royal Army Medical Corps, “of the un¬
scientific, nay anti-scientific, tone of the service”,
had been strengthened by what he had heard from
correspondents. This month’s Classical Review con¬
tained a review by him of an edition of Galen’s
Libellus de Captionibus.

The more complete co-ordination of the teaching
given by the University and Colleges at Cambridge
was then attracting attention, and on February 15
a fly-sheet with certain suggestions and the signatures
of Allbutt and many others appeared. On March 1
the new science laboratories and the Medical School
in Downing Street, Cambridge, were formally opened
by King Edward VII. and Queen Alexandra; at the
Medical School they were received by the Regius
Professor, supported by the Downing Professor of
Medicine (J. B. Bradbury), the Professor of Surgery
(Howard Marsh), and others. On May 12 he was in
Leeds and gave an address on opening a new Public
Dispensary erected at a cost of £33,000, and on May
23 he wrote a long letter to the British M edical Journal 1
criticizing the editorial comments in that journal on
the Government Bill to amend the Lunacy Acts.

At the annual meeting of the British Medical
Association at Oxford in the last week of July he
proposed the vote of thanks to the President, Dr.
William Collier, who was a Cambridge graduate, for
his address on “The Growth and Development of
the Oxford Medical School”. This was seconded by
Osier, who soon afterwards accepted the Regius Pro¬
fessorship of Medicine at Oxford in succession to Sir
John Burdon-Sanderson, who had resigned. At the
meeting of the British Association at Cambridge,

1 Bril. Med. Joum., 1904, i. 1286-87.

165

SIR CLIFFORD ALLBUTT

Allbutt1 took part in the discussion in the Section of 1904
Physiology, of which Professor C. S. Sherrington was
President, on “The Relation of Oxidation to Func¬
tional Activity”, introduced by Sir John Burdon-

Sanderson on August 19.

In September he went to America to attend the
meeting of the Congress of Arts and Sciences on
September 19-25, in connection with the World’s
Fair and Exposition at St. Louis, Missouri. This Con¬
gress, which was largely organized by Miinsterberg, the
Professor of Psychology at Harvard, who was a very
active German agent before the War, was divided into
twenty-four Departments, that of Medicine, undei
the chairmanship of Professor (later Sir) William
Osier, consisting of twelve sections. The British
readers of addresses in these sections of the Depart¬
ment of Medicine were Allbutt (Internal Medicine),
Brunton (Pharmacology), Ronald Ross, then of Liver¬
pool (Preventive Medicine), and Felix Semon (Oto¬
logy). The medical addresses are contained in the
sixth of the twelve volumes giving an account of the
Congress. In the Section of Internal Medicine two
addresses were given: Professor W. S. Thayer, of the
Johns Hopkins Hospital, discussed the internal rela¬
tions of medicine in his “Problems of Internal Medi¬
cine”2 on September 22, and traced its progress,
mainly during the previous hundred years, throwing
out a caution against too early specialization in the
medical curriculum at the expense of the humanities
and general culture. Allbutt spoke, from the point
of view of the outward relations of internal medicine,

1 Rep. Brit. Assoc., Cambridge, 1904, p. 748.

2 Am. Med., 1904, viii. 915-18; Science, New York, N.S., xx.
700-15.

166 SIR CLIFFORD ALLBUTT

1901 on “The Historical Relationsof Medicine and Surgery
to the end of the Sixteenth Century”,- insisting on
icn artificial separation, which dated from the time
of Avicenna, a.d. 1000, and had given rise to two
pioftssions, and pointingout that previously medicine
had been one and undivided, and surgery not a dis-
mct department of the healing art but an alterna-
tive method of treatment. “Physic,” he said, “was
Sterile in proportion to its divorce from Surgery”.
This appeal for the essential unity of the healing
art he illustrated by two comparatively modern in¬
stances: “About this time (1864), when indeed few
ellows of the London College of Physicians would
condescend even to a digital examination of rectum or
uterus, certain of them, concerned with the diseases
ot women, began to make little operations about the
uterus; and, meeting after all with but slight rebuke
they rode on the tide of science and circumstance'
encroaching farther and farther, until they were dis¬
covered m the act of laparotomy; and, rather in
dehance than by conversion of the prevailing senti¬
ment of that Corporation, they went on doino- it”;
and again: “In cerebral surgery for instance is it
not absurd for one institution to deny, let us say, to
Sir William Gowers and Professor Ferrier a liberty
which by another institution is granted, let us sav,
to Professors Horsley and Macewen?” In later years
he often instanced the gynaecologists, who assumed
complete control of the female pelvis, as an example
of what physicians should aim at; namely, to be com¬
petent to carry out all methods of treatment in the
part of the body on which they specialized; thus a

' L“ncet’ 1904> “• 735> and in L^ok form, pp. xvi. and 125. London,
Macmillan & Co., 1905.

SIR CLIFFORD ALLBUTT 167

physician interested in thoracic diseases should be 1904
recognized as the proper person to perforin a neces¬
sary operation on the chest. The following paragraph
well presents the argument for the study of medical
history:

As we cannot know any part of an age or people without
an idea of the whole, nor take to ourselves a lesson from
other times and other folk without some conception of their
nature and fashion, so we cannot know modern Medicine
unless we study it as a whole, in the past as well as in the
present. From Greece and medieval Italy we have to bring
home the lesson that our division of Medicine into medicine
and surgery had its root not in nature, nor even in natural
artifice, but in clerical feudal and humanistic conceits.

This address, published in full in the following year,
bears the graceful inscription: “To my generous
American Friends : Friends as generous in their Hos¬
pitality to the Stranger and their Appreciation of
his diffident service as in their Love of Learning, this
Tract is dedicated”.

On October 5 he was in Baltimore and gave an
address at the opening of Osier’s new clinical amphi¬
theatre at the Johns Hopkins Hospital. By October
8 he reached New York on his way home, and the
late Dr. J. S. Billings of the New York Public Library
noted on that day: “When I went up to the library I
found Dr. Clifford Allbutt of Cambridge reading the
last number of ‘Punch’, and very much at home”.

In a letter to “The Times” of November 22, com¬
menting on a leading article dealing with physical
education, he insisted on the paramount importance
of considering the question of diet in all schemes of
physical education, and drew attention to metabolic
experiments and results obtained by Atwater and

168 SIR CLIFFORD ALLBUTT

1904 Chittenden in America. “The Times” of November
29 contained a long letter from him under the head¬
ing of “Lunacy”, in which, stimulated by the late Sir
William Gowers’ recent address to the Medico-Psy¬
chological Society, he criticized the existing system
of the ti eatment of the insane, and offered some con¬
structive suggestions. To begin with, the ill-omened
words “lunacy” and even “asylums” should be got
rid of; it may be noted that for the second of these
words “mental hospitals” has come into vogue. He
continued: “for the main work, colonies — that is,
public paiks containing a hospital and various villas
—should be provided by the local authorities”.

1905

In “The Times” of January 4 there was a long
letter from him on the subject of “Obligatory Greek’\
a question then very keenly discussed at Cambridge, ?
where he was among those in favour of making it
optional in the Previous Examination. He spoke in
the debate in the Senate House, and subsequently
published his considered opinion in a fly-sheet of eight
pages, which began: “In my speech I said that, to
save the time of the Senate, I would then omit certain
parts of my matter, and take another opportunity of
laying them before the University. Now I have fallen,
fondly I fear, into the temptation to print in full the
notes I had made for myself before the debate. It is
to the function of speech as of the essential nature of
a language that I would venture to call special atten¬
tion; for this physiological truth has a far wider bear¬
ing than we have in view of our previous delibera¬
tion.” When setting out this argument, he pointed

169

SIR CLIFFORD ALLBUTT

out that classical Greek could never again be a spoken 1905
language in the West, and went on: “I am convinced
that if a language is to be an effectual instrument of
general education it must enjoy that which is of its
essence: it must be a speech— a tongue. Physicians
know well that the relations between the motor
factors of a language and the development of its
thoughts are not only intimate but are organically
integrated in the brain. If we make Greek optional
we can thereby raise our standard of Latin; and in
place of the sterile methods of cramming little boys
with the abstruse propositions of grammatical peda¬
gogues, we may start them as — if we had but eyes to
see_nature herself starts them, by way of the physio¬
logical instruments of language.” Like the status of
women in the University, the retention of compulsory
Greek in the Previous Examination was a recurring
problem, and it was not until January 1919 that it
was finally settled by being made optional.

Active University Libraries are continually in
want of room for expansion, and the special appeal,
issued by the Vice-Chancellor (E. A. Beck), the Libra¬
rian (Francis J. H. Jenkinson), and J. W. Clark,
Chairman of the Library Appeal Sub-Committee
appointed by the University Association, began its
statement to Members of the Senate and Friends of
the University: “The Library of the University of
Cambridge occupies a unique position. It is the only
Library in England, perhaps in Europe, of which it
can be said that after a continuous existence of nearly
five hundred years, and after all the vicissitudes
through which it has passed, it is still used day by
day by the members of the corporate body to which
it belongs, with the freedom of its earliest organiza-

170

SIR CLIFFORD ALLBUTT

1905 tion.” As would naturally be expected, Allbutt was

among the first to come to the rescue with a generous
donation.

On January 11 he was at Bristol to deliver an
address on “The Prevention of Apoplexy”1 to the
Bristol Medico-Chirurgical Society. In a brief but
interesting philosophical introduction he traced the
progress of medicine as expressed up to the era of
Morgagni and morbid anatomy in the eighteenth
century by the question, “What is Disease?” then by
the problem, “Where is Disease?” and now by the in¬
quiry, “How is Disease?” or what is the genesis of
moi bid piocesses, and by the answer to this etiologi¬
cal question to find the sure road to the prevention
of disease. As a safeguard against the insidious rise
of blood-pressure which early lays the mine, which
when it explodes is cerebral haemorrhage, he recom¬
mended that as a matter of routine every adult of
forty years of age and upwards should have his blood-
pi essure taken, and this process repeated everv five
years until about the age of sixty years, when, if there
is not any great increase in the blood-pressure, the
danger of cerebral haemorrhage may be disregarded.
In his last publication on the subject, in 1925, he ex¬
pressed an adverse opinion on such periodic examina¬
tions.

On February 5 he gave the Friday evening dis¬
course at the Royal Institution of Great Britain,
Albemarle Street, with Sir William Crookes in the
chair. The subject of “Blood-pressure in Man”2 was
illustrated by lantern slides and by Dr. W. E. Dixon’s
demonstrations of a number of the points raised,

Bristol Med.-Chir. Joum., 1905, xxiii. 1-10.
2 Nature, London, 1904-5, Ixxi. 075.

SIR CLIFFORD ALLBUTT

171

such as the difference in vascular efficiency under
muscular exertion in a young and in an elderly man.
In this month his review1 of C. Kalbfleisch’s edition
of Galen’s De Causis continentibus Libellus ap¬
peared. On April 26 he opened a discussion on in¬
fluenza,2 and was followed by Dr. Franklin Parsons,
who spoke on the epidemiological problems, at the
Hunterian Society of London. In a broad survey of
the subject Allbutt touched on points of practical
importance; thus he said : “I am quite sure that no
patient for some time after influenza ought, for
empyema or the like, to have chloroform as an
anaesthetic”.

In May a number of British physicians accepted
the invitation of their French colleagues to go to
Paris, and Allbutt, who had been in America when
the French medical men visited London, October 10-
12, in the previous year, was a prominent member of
the party. At the initial reception on the evening of
May 10, at the Sorbonne, by M. Liard, Rector of the
University, he spoke in excellent French, and to¬
gether with the late Sir William Broadbent, who was
the leader of the visitors, was presented with a gold
medal as a souvenir of the occasion. At the grand
banquet on May 12, which was the official conclusion
of the visit, he was again one of the speakers.

On October 3, 1905, at the opening of the winter
session at King’s College Hospital he delivered an
address on “Medical Education in London”, sub¬
sequently published in book form by Macmillans in
1906 with the broader title “On Professional Educa¬
tion, with Special Reference to Medicine”. In it he

1 Classical Ilev., London, 1905, xix. 59-00.

2 Brit. Med. Juurn., 1905, i. 977.

1905

172 SIR CLIFFORD ALLBUTT

1905 remarked: “If I may contribute my dole to a current
controversy, I would opine that no teacher reaches
his best till middle life. Not till then does he gather
the fruits of experience, or attain to a rich and vital
sense of our ignorance; not till then does he wholly
escape from formulae and routine; not till then does
he learn what to leave unsaid; then it is that erudi¬
tion and experience mellow into wisdom.” The
“current controversy” was that raised by Sir William
Osier’s valedictory address, “The Fixed Period”,
delivered on February 22, 1905, at the Johns Hopkins
University, Baltimore, in which he referred to “the
comparative uselessness of men above forty years
of age”, and was hurriedly and erroneously inter¬
preted by a certain section of the lay press as advo¬
cating the painless extinction by chloroform of men
over sixty years of age, so that the verb “to Oslerize”
actually got into a popular dictionary. Allbutt in a
footnote to this address at King’s College Hospital
had a sly dig at his brother Regius to the effect
that “thus Regius Professors may supplement each
other’s researches”. In this address he insisted that
the function of a university is not qualification for
the practice of any art or trade, but a training of
the mind, a formation of habits of study, of insight,
of easy handling of ideas, and the development of
imagination.

On October 19 the anniversary of Sir Thomas
Browne’s birth in 1605 was celebrated at Norwich,
and Lord Avebury, better known as Sir John Lub¬
bock, unveiled a memorial statue in the open part of
that city known as the Haymarket. Allbutt repre¬
sented the University of Cambridge, and in second¬
ing a vote of thanks to Lord Avebury, said that as

SIR CLIFFORD ALLBUTT 173

Sir Thomas Browne was great as a man of science, 1905
greater as a naturalist, and greater still as a man of
letters, it was with singular fitness that Lord Ave¬
bury, who was a great man of science, a great natur¬
alist, and no less renowned as a man of letters, should

preside at the celebration.

In October Bishop John Gott (1830-1906), an
old friend from the time (1873-86) when he was
Vicar of Leeds, was staying with the Allbutts, and
the following extract from a letter written by him
on October 19 shows the trust that Allbutt’s friends
had in his professional advice and the trouble that
he devoted to them: UI have just returned from
Clifford Allbutt at Cambridge; he spent all yesterday
morning in examining me, and was considering me
through my two days with him. So I have given my¬
self every chance, you see. His report is far moie

favourable than G - ’s— not that I was afraid of

angina, yet I am glad for some reasons that don’t so
much affect me, that there is no trace of it in me.
Only I must slacken down, and do no public work
for a time.”

In a paper on “The Importance of Blood-pressure
in Clinical Medicine”,1 published in October, he out¬
lined the preventive and early treatment of the
subjects of hyperpiesia, who, though not as a rule
the victims of frank gout, often come of a gouty
stock. After discussing the dietetic and drug treat¬
ment he gave some advice which is of personal in¬
terest as showing what he, with a gouty inheritance,
did to keep himself in good health. “There is one
systematic cure or preservation in incipient or
mildly recurrent cases which is better than spas and

1 Hospital, London, 1905-G, xxxix. 21.

174

SIR CLIFFORD ALLBUTT

I90o medicines, and this is mountain climbing. Let the
person thus liable get away twice a year into the
hills, as to Switzerland, Cumberland, or Scotland;
not to shoot driven game, to eat a hot lunch, and
ride home in a motor car, but to march up and down
hill for a month from morn to eve, with no more than
a crust of bread and a handful of prunes in his pocket,
lhis I do in Switzerland and the Lakes, keeping
watch on my blood-pressure. I have never again had
to go Homburg, as I had to do some summers ago,
when for two years I had been barred by other en¬
gagements from my climbing propensities. After a
veek or ten days on the glaciers the pulse will be¬
come as gentle as the pulse of a child.” On November
14, at the Medico-Legal Society, Sir Wilmot Herrino-
ham introduced a discussion on the subject of con¬
sultation among medical witnesses before trials, and
Allbutt sent a memorandum describing the plan he
had been instrumental in getting adopted in Leeds

with great success a quarter of a century before
{vide p. 78).

On the death of Sir John Burdon-Sanderson
(1828-1905) he wrote a charming appreciation1 of
the late Regius Professor of Medicine at the sister
University, whom he first met through Wilson Fox.
Sanderson, when uncertain whether he should devote
his life to science or to medicine, and also a bachelor,
had stayed in Leeds with Allbutt, who wrote: “I see
him vividly now as he was on that first visit to me,
rather elegant in appearance, leaning in the light of

a bay window, discoursing on the sphygmograph _ a

discourse from which I derived the sources of my sub¬
sequent interest in the problems of the circulation”.

1 Brit. Med. Joum., 1905, ii. 1489.

SIR CLIFFORD ALLBUTT

175

1906

At a conversazione of the Classical Association, 1906
of which he was a member, held at King’s College,
London, on the evening of January 5, he gave an
address on “The Speaking of Latin”,1 urging, much
on the same lines as in his fly-sheet about Greek in
the previous year at Cambridge, that this was the
way in which it should be taught, and regretting that
“so fast are we bound to the modern convention
that a language, if not dead, ought to be, that school¬
masters exhibit a withering contempt for languages
as tongues, and protest that to speak a language is
but the trick of a parrot, or the showy and super¬
ficial accomplishment of those French and German
classes which are being foisted into our schools and
universities by a utilitarian public”.

In a clinical lecture on three cases of arterial
disease2 he insisted that by “a disease” is meant “a
group of symptoms which recurs with approximate
constancy, and to which therefore it is convenient
to attach a label or name: moreover that, as similar
events must result from similar causes, no approxi¬
mately constant group of symptoms can result from
different causes”. This lecture provoked consider¬
able interest, as shown by the resulting correspond¬
ence. Later in the spring he wrote two letters3 com¬
menting on a case, reported by Dr. Curtis, of angina
without apparent disease of the heart or blood-vessels.

On February 7 he was in Edinburgh as the guest of
the students’ Royal Medical Society, which, as it

1 Proc. Class. Assoc., 1906, p. 19.

3 Brit. Med. Journ., 190(5, i. 5.

3 Ibid., 1906, i. 919, 1070.

176

SIR CLIFFORD ALLBUTT

1906 was founded in 1734, is therefore the oldest existing
medical society, and is the only students’ medical
society with a Royal Charter, obtained in 1778 by
the exertions of Caleb Hillier Parry (1755-1822),
afterwards “the distinguished old Bath physician”,
as Osier called him, and the first describer of exoph¬
thalmic goitre. In his reply to the toast of his health
Allbutt referred to the eminent men who had adorned
the Society, and passing on to speak about medical
education, mentioned the advantage after qualifica¬
tion of having a year’s training by working with a
medical practitioner. On the following day he attended
the late G. A. Gibson’s clinic at the Royal Infirmary,
and addressed some remarks on cardio-vascular
disease to the class. In March, when the late Dr.
Hugh Walsham gave a lecture at Cambridge on the
use of X-rays in diagnosis, Allbutt naturally spoke
at the meeting.

When King Edward VII. Sanatorium for Tuber¬
culosis at Midhurst was opened in 1906, Sir Clifford
was one of the original twelve consulting physicians
who each make an annual visit, one for each month,
to inspect the hospital generally, examine patients,
and write a considered report which is circulated to
the other consultants. This duty he enjoyed, and,
like all his numerous engagements, performed with
scrupulous regularity up to the end of his life. On
March 14 he was appointed consulting physician to
the Mount Vernon Hospital for Diseases of the Chest,
then and until 1914 in Hampstead, and thus was a
colleague of James Mackenzie for three years (1909-
1912). During this month lie was in Amblcside, and
on his way south to attend a meeting of the Com¬
mittee of the Athenaeum, stopped with the late Sir

SIR CLIFFORD ALLBUTT

177

Charles Brown at Preston to visit the Infirmary, and 1906
was naturally much interested in his host’s chamber
organ. The visit was returned on July 15-16, when
Sir C. Brown stayed at St. Radegunds to discuss the
Research Hospital at Cambridge. “The Times” of
June 5 and 21 contained letters from Allbutt about
the desirability of establishing a chair of Comparative
Medicine at Cambridge.

At the formal constitution of the Pathological
Society of Great Britain and Ireland, at a meeting
held in the Victoria University of Manchester on July
14, Allbutt and Osier both assisted at the birth of a
vigorous offspring, which has now about 400 mem¬
bers. At that time J. Lorrain Smith, who had been
John Lucas Walker student in Pathology (1892) and
Demonstrator of Pathology (1894) at Cambridge,
was Professor of Pathology at Manchester. The J our-
nal of Pathology and Bacteriology, which became the
official journal of the new society, was founded in
1893 by German Sims Woodhead (1855-1921), who
in 1899 succeeded the late A. A. Kanthack as Pro¬
fessor of Pathology at Cambridge, and was edited by
him continuously up till the end of 1920. An editorial
in the Journal for January 1922 says that “it was by
his generosity and his practical interest in the incep¬
tion of the Pathological Society of Great Britain and
Ireland that the J ournal became the official organ of
the Society”.

On August 4 Allbutt received the honorary degree
of D.Sc. at Leeds, and then made a hurried visit to
attend the Toronto meeting of the British Medical
Association and to receive the degree of LL.D. hono¬
ris causa from the Universities of Toronto and McGill,
Montreal. In the section of Medicine, presided over

N

178

SIR CLIFFORD ALLBUTT

1906 by Sir Thomas Barlow, he read a paper on the relation
of blood-pressure to arteriosclerosis on August 21,
and two days later, at a joint meeting of the sections
of Medicine and of Pathology and Bacteriology, took
part, together with Adami, Aschoff of Freiberg, and
Klotz, in a discussion on the forms of arteriosclero¬
sis, opened by Professor W. H. Welch of Baltimore.
In his contribution entitled “Clinical Remarks on
Arteriosclerosis” he took the opportunity of insist¬
ing that arteriosclerosis is not a clinical disease — is
not manifested by a uniform or approximately uni¬
form series of symptoms, but is a pathological change
which may be of several kinds; thus, as he had pre¬
viously pointed out in 1903, there were three classes:
the toxic, for example, syphilitic; the hyperpietic,
which might be either independent of or associated
with kidney disease; and the involutionary, a senile
or quasi-senile degradation.

After a crowded week or less in Canada he re¬
turned to England, and opened the winter session
at the Guy’s Hospital Pupils Physical Society,
founded in 1771, and so the oldest surviving medical
society in London. In an address on “Words and
Things”,1 dealing with the correct application of
names to diseases, he said: “Some of you who have
heard my teaching before must forgive me if I re¬
peat my insistence that the name of a disease is not,
as it is continually regarded, a thing. There is no
such thing as typhoid fever, as angina pectoris, as
spleno-medullary leukaemia, and so forth; the things
so called are Wilkinson, Johnson, and Thompson,
who after their kinds arc afflicted not alike, but within
such limits of similarity as to lead us to class them

> Lancet, 1906, ii. 1120-25; Guy's IIosp. Gaz., 1906, N.S., xx. 448.

SIR CLIFFORD ALLBUTT

179

together and to form a general conception of them.” 1906
He thus expressed in graphic language Claude Ber¬
nard’s definition of disease as a physiological reaction
in altered circumstances, and the opinion of Erasi-
stratus (300 b.c.), as he later pointed out in the
FitzPatrick Lectures, that disease is a perversion of
normal processes and not a condition contrary or
foreign to biological nature. He said: “Remember
that, when it is asked if such and such a group of
symptoms be ‘a morbid entity’ or not, that since the
day of William of Ockham we have given up entities,
that the question is now one only of convenience of
reason; but that when we have once agreed to give
a certain name to a certain morbid series of events —
arbitrarily agreed, that is — then we must stick to our
label; for if the label is to be shifted about, or the
things under it shifted, all accurate reason comes to
an end”. He ridiculed the use of pseudo-compounds,
such as pseudo-angina. A little later he wrote a
letter1 about the use of the word prodr omata as a
plural word, in response to one by Sir William R.
Gowers, who confessed that he had been an offender
in this respect; Allbutt, however, in his comment was
by no means dogmatic in saying that it was wrong.

In a letter to “The Times” of December 26, in con¬
nection with the subject of the prevalence and treat¬
ment of insanity, which had then been much dis¬
cussed, he said that, though the system of public
asylums is honourable and humane in intention, it
was in a scientific sense a gigantic muddle.

1 Lancet, 1906, ii. 1304.

180

SIR CLIFFORD ALLBUTT

1907

1907 To the January number of the Practitioner,1
which was specially devoted to the consideration of
influenza, he supplied the introduction, and was fol¬
lowed by the late Sir Richard Douglas Powell, Sir
William Broadbent, Sir Dyce Duckworth, Sir John
Moore of Dublin, Dr. Samuel West, and others. In
the same month the first number of the British
Journal of Tuberculosis 2 appeared, and here again he
wrote the first article, “The Study of Tuberculosis: a
Retrospect”, in which he gave his early recollections
of the treatment of pulmonary consumption when
fresh air was anathema ( vide p. 7). “The Times” of
January 2 contained a letter from him on the subject
of insanity, in which he deplored the want of research
in connection with mental hospitals, and insisted
that by research must not be meant laboratory work
alone, for it is really “methodized and disinterested
practice, and must be exercised not only on the arti¬
ficial systems of the laboratory, but also on the rich
variety of nature. Nevertheless, at any rate in recent
times, discovery has been achieved only by special¬
ists who can give all their time and energy to it with¬
out thought for bread.” Therefore, he said, young
men, highly trained, should be so paid as to be able
to give their whole time to the investigation of the
causation and cure of disease.

In 1907 an influential committee for the study of
special diseases was established, consisting of Clifford
Allbutt, William Osier, William Church, Jonathan
Hutchinson, Richard Douglas Powell, Henry Morris,

1 Practitioner , London, 1907, Ixxxviii. 1-10.
2 Bril. Journ. Tuberc., London, 1907, i. 5-10.

SIR CLIFFORD ALLBUTT

181

W. Watson Cheyne, Howard Marsh, Thomas Barlow,
Victor Horsley, and Donald MacAlister. Its object
was to promote the scientific investigation of chronic,
incapacitating, but not immediately fatal diseases.
At first a small house in Hartington Grove, Cam¬
bridge, was utilized as a research hospital, where
relays of a few patients at a time, with rheumatoid
arthritis, were thoroughly investigated by the late
T. S. P. Strangeways (1866-1926), whose enthusiasm
drew workers to his side, and led to the issue of
volumes in 1905, 1907, 1908, and 1910 of the Bulletin
of the Committee for the Study of Special Diseases. In
1911 the foundation-stone was laid, and on May 24,
1912, the Cambridge Hospital for Special Diseases
was formally opened and declared free from debt by
the late Sir Charles Brown (1836-1925) of Preston,
who, influenced by Allbutt, was a most generous
benefactor to this experimental or research hospital,
founding a studentship in pathological research, and
providing a photomicrographic outfit and a complete
X-ray apparatus. He also bequeathed his “body to
the Directors of the Research Hospital, Cambridge”,
authorizing them “to retain such parts of it as they
consider may be suitable additions to their patho¬
logical museum”. In accordance therewith his brain,
hip, finger, and bladder were placed in the Museum.
Allbutt had taken the greatest interest in the hos¬
pital from its inception, spoke at the opening, and
paid a tribute to Strangeways’ work on rheumatoid
arthritis, mentioning that he had carefully analyzed
4000 specimens. The Strangeways Collection of rheu¬
matoid joints is now in the Museum of the Royal
College of Surgeons of England.

In July 1907 Allbutt wrote a fine appreciation of

1907

182 SIR CLIFFORD ALLBUTT

1907 his old friend Sir William Broadbent (1835-1907),
who was born near Huddersfield: “His was the sturdy,
righteous temper which has been the making of Eng¬
land and which we northern men are proud to think
has been largely, though by no means only, ours”.

Allbutt’s creation as a K.C.B. (civil) in the Birth¬
day Honours list on November 9 met with wide ap¬
proval as an honour long overdue, for he had already
been fifteen years Regius Professor, which, with the
corresponding appointment at Oxford, may reason¬
ably be regarded as coming after the Presidents of
the two Royal Colleges in London in the rank of the
profession. As he wrote to a correspondent some five
years before in reply to an expression of regret that
his claims to such a recognition had been overlooked,
Allbutt did not in the least care for such distinctions,
and had indeed declined overtures with regard to a
knighthood before he was appointed to Cambridge.
Personally, he “would not have crossed the street to
ask directly or indirectly for any honour in the world”.
He did, however, think that in order to induce lead¬
ing physicians to give up the worldly rewards of a big
practice elsewhere and take up the duties of “a hard-
worked post with small salary and great claims upon
it”, some such recognition was important. Otherwise
the principle of appointing someone drawn from the
wider field of practice, not a mere academic person
or one brought up in local routine, might not be
found to work in the future. When the honour was
made public he was of course snowed under with
congratulations, which gave him real pleasure, as
the following reply to a friend whom he had known
since 1800, shows:

SIR CLIFFORD ALLBUTT

183

St. Radegunds, Cambridge,
November 16, 1907.

My dear Crichton-Browne — I must from this splendid
pile pick out your letter as one of the most welcome for early
acknowledgement. In the more than kind and generous
words in which you express your congratulations, I should
have read chiefly the very agreeable regard of an old and
dear friend, had they not received a supporting testimony
from within and without the profession which I can hardly
quite realize and can never bring myself to believe. Still, that
I should have seemed to so many people to be such an one,
cannot but be joyful and especially that I have sustained
the honour of the Chair which I have tried to occupy
worthily. This is sad egoism but you must accept the blame
of it for your cheering message. If you realized the pleasure
it is to me to reply to it, you would not tell me to receive
it in silence.

Of all the benefits and kindnesses I have received from
you none are forgotten, many as they are — none is so much
valued as the gift of your forty years’ friendship.

When the honour was announced he was in some
little doubt whether he should call himself Sir
Thomas, as he wished to do because it was his
father’s name, or Sir Clifford, because he was gener¬
ally known as Clifford Allbutt. More often dropping
the T., he sometimes retained it, and occasionally
signed obituary notices and reviews C. A., but every¬
one spoke and wrote of him as Sir Clifford.

In an article which appeared on November 1C,
just a week after his creation as K.C.B. but before
the King had conferred the accolade upon him, he
was curiously but rightly described as Professor T.
Clifford Allbutt, K.C.B., M.D., F.R.S. In this account
of “The Senile Cardio-vascular System”1 he divided
the life of man into three periods: the first thirty

1 Hospital, London, 1907, xliii. 159-61.

1907

184

SIR CLIFFORD ALLBUTT

1907 years as that of acute infections, the second from
thirty to sixty as that of chronic infections and
maladies such as gout, cancer, and diabetes, and from
sixty or sixty-five to ninety as the period of slowly
advancing senility or preparation for death. He was
then just over sixty-one years of age, and the only
inconsistency he was ever guilty of was in never
conforming to his dictum as to the state of those
between sixty and ninety, for he was most active in
every respect up to the day of his death, and his mind
never got rigid, as so often occurs with prolonged
life. In this article he introduced the adjective de¬
crescent to designate the arterial changes seen in the
last period, in preference to involutionary, which is
open to the objection that arteriosclerosis is not a
necessary accompaniment of old age. He then spoke
of hyperpiesia, or idiopathic high blood-pressure,
which he regarded as the cause rather than the con¬
sequence of arteriosclerosis; raised blood-pressure, he
pointed out, must be due to one of two factors, either
viscosity of the blood or more probably widespread
constriction of the vessels in the splanchnic or nuis-
culo-cutaneous systems. He wrote the article on
arteriosclerosis in Hutchison and Collier’s (after¬
wards Sherren’s) successful Index of Treatment, the
eighth edition of which came out in 1921.

Like W. E. Gladstone, he seldom declined a chal¬
lenge to enter into debate; thus, under the heading,
“What do we mean by Tachycardia?”1 he gently
defended himself against the suggestion that he had
been guilty of “taking a word of general import and
using it without qualification in a limited sense” in
his article in the first edition of his System of Medi-

BTit. Med. Joitrn., 11)07, ii. 938.

1

SIR CLIFFORD ALLBUTT

185

cine (1898, v. 824) dealing with what has commonly 1907
been called paroxysmal tachycardia. In that article
he had not employed the adjective “paroxysmal”, and
almost at the outset had remarked: “If any rapid
pulse, ranging, let us say, over 130, is to be decor¬
ated with this fine name there is an end to clinical
nomenclature”. On December 8 he was appointed to
the Consulting Staff of the Convalescent Home for
Officers of the Navy and Army at Osborne, Isle of
Wight, and as usual was most punctilious in his yearly
visits and in his reports.

During the final examination for the M.B. on
December 17 and 18, his College — Gonvilleand Caius
— gave a dinner to celebrate his K.C.B., at which very
interesting and sympathetic speeches were made in
his honour by Sir William Osier, who was one of the
examiners, and the late Howard Marsh, Professor of
Surgery (1903-15), who had recently been made
Master of Downing.

1908

He was now finishing his term of two years as
Censor at the Royal College of Physicians of London,
which entailed attendance at the quarterly examina¬
tions for the membership and other meetings for
various kinds of College business. The Censors’
Board, as the name implies, is the College Committee
for dealing with Fellows, Members, or Licentiates
who act contrary to the bye-laws and regulations of
the College or have committed any offence, such as
those judged by the General Medical Council to
constitute “infamous conduct in a professional re¬
spect”. The Censors’ Board consists of the President

186

SIR CLIFFORD ALLBUTT

1908 and the four Censors, and should any one of them
fail to attend or to provide an approved substitute
no business can be transacted; so, though as a rule
not very frequent, except about the beginning of
each quarter of the year, the meetings are a serious
engagement; furthermore, the revision of the by¬
laws and regulations of the College, which took
place during his term of office, must have necessi¬
tated many additional meetings. During this year
Sir James Mackenzie (1853-1925), who had left
Burnley the previous year to settle in London, sub¬
mitted himself for the membership; Allbutt, as a
member of the Censors’ Board, was one of the exam¬
iners, and afterwards described this as “a comedy”.

Early in the year Allbutt expressed his views on
empiricism and instinct in veterinary medicine,1
and must have been busily engaged in j^reparing the
FitzPatrick Lectures on the history of medicine,
which he had been selected to give in 1909 and 1910,
and in writing other addresses.

On May 28 he was elected the representative
of the University of Cambridge on the General
Medical Council in succession to Sir Donald Mac-
Alister, the President of the Council since 1904,
who in the previous year had migrated from Cam¬
bridge to become Principal of Glasgow University.
Before Sir Donald left Cambridge he was naturally
entertained at a farewell dinner, and in a happily
expressed speech Allbutt playfully referred to this
exceptional circumstance of a Scot returning from
England to take up an appointment in his native
country. By one of those accidents which may occur
with even the best of secretaries the guest on this

1 Brit. Med. Juurn.y 1908, i. 231.

SIR CLIFFORD ALLBUTT

187

occasion was not invited until the day before the 1908
celebration. For two periods of five years Allbutt
was a member of the General Council of Medical
Education and Registration, to give its full title,
which has much of its time when in session occupied
by the unpleasant and often tedious duty of hearing
charges against members of the medical profession
for penal offences and advertising. In May 1918 he
was succeeded in this necessary function by Pro¬
fessor (later Sir) Gowland Hopkins.

The August number of the Classical Review con¬
tained an essay-review from him on Celsus, founded
on a German translation of Celsus’ De Medicina.

On October 1 he was at Manchester to deliver
the introductory address at the opening of the
winter session of the Medical Department of the
Victoria University. This address, on “Hospitals,
Public Medicine, and Medical Education”, was pub¬
lished in the Lancet (1908, ii. 1055), commented on
in a leading article in the British Medical Journal
(1908, ii. 1124), and brought out in pamphlet form
by the Manchester University Press. It gave a wide
survey of the field of medicine, dealing with the
management of hospitals and touching on the re¬
lations between the lay governors and the medical
staff, clinical pathology, out-patients, the relation of
universities to technical instruction, and on medicine
and the State. In speaking on the last important
subject he said that what was wanted was the
establishment of a General Staff of Medicine or a
Ministry of Health, such as, in fact, was set up after
the War. On October 2 he was at Leeds, when,
on behalf of the subscribers, the late Dr. J. E.
Eddison, his former junior colleague, presented to

188 SIR CLIFFORD ALLBUTT

1908 the General Infirmary the portraits of Allbutt (by
A. S. Cope, A.R.A.) and T. Pridgin Teale (by W. W.
Ouless, R.A.), and in doing so pointed out that they
both were elected to the staff of the Infirmary in
1864, resigned on the same day on account of the
expiration of the term of years, and had taken an
active part in the building of the new Infirmary
which was opened in 1869. After this ceremony
Allbutt presented the prizes to the students in the
Medical School and gave an address.

Shortly after this he took part in the discussion1
at the Medical Section of the Royal Society of
Medicine on Sir Wilmot Herringham and Mr. F.
Womack’s paper on “The Resistance of Arteries to
External Pressure”. In an address on “The Treat¬
ment of Angina Pectoris”2 he said that though too
often, nay, almost universally, regarded as inevit¬
ably fatal, this disease is of all perilous maladies
perhaps the most curable, for primarily it is not a
fatal disease, though secondarily, by reflex inhibi¬
tion of a frail heart, it frequently kills. He also drew
attention to the opinion long held, but first pub¬
lished in 1894, by him that in ninety-eight out of a
hundred cases it is a painful lesion of the first part
of the aorta. The contrast between science and
empiricism was remarkably seen in connection with
the use of iodides in arterial diseases — in arterio¬
sclerosis, aneurysm, and angina pectoris — for whereas
their value is universally admitted by clinicians, no
explanation of this has been obtained experimentally.
With regard to the use of nitrites he threw out a cau¬
tion, as he had noted a disposition to a nitrite habit.

1 Froc. Hoy. Soc. Med., 1908-9, ii. (Med. Sect.) 37-49.

2 Folia therap., London, 1908, ii. 3-G.

SIR CLIFFORD ALLBUTT

189

1909

On January 12 he gave the Presidential Address 1909
at the annual meeting of the Public School Science
Masters on “The Function of Science in Education”,1
and urged the importance of scientific instruction in
schools. He said that science was busily engaged in
remodelling and re-interpreting every branch of
education and all the walks of life for which they
are a preparation. Without the slightest intention
of marshalling science in opposition to the humane
and other arts, it was his vocation to insist “that as,
in their date and degree, all human things fade,
science is the means by which we recover from
them the principles of strength and beauty, and
learn to adapt the newly won principles to new
creations — a point of view quite consistent with
the pursuit of what is called ‘classical’ culture”.
Science was not a hobby, not even a modern system
of utilitarian ingenuity, but a way of observing and
interpreting everything, including religion. He con¬
cluded with the disarming appeal that his address
would be in vain if he had not half persuaded even
the headmasters that no boy’s education was broad
and symmetrical which did not include enough science
to enable him to pass an examination such as that
of the first M.B. at Cambridge. In the discussion
following Mr. G. Bernard Shaw’s address on “The
Socialist Criticism of the Medical Profession” at a
meeting of the Medico-Legal Society on February
16, Allbutt remarked: “I really think it would not
pain Mr. Shaw much to say that we — most of us —
agree with very much that he has said”. But with

1 The School World, 1900, xi. 01.

190 SIR CLIFFORD ALLBUTT

1909 regard to the remarks about medical men revelling
in an epidemic of smallpox he felt bound to refer
to an extremely able doctor in one of the Yorkshire
Dales with a practice worth £1200-£1400 per annum,
who, having to fight an epidemic of typhoid fever,
set himself day and night to solve the problem of
prevention; thus after twenty years he eradicated
the disease, but in the process he lost his sleep, broke
down his health, and reduced his practice by half,
at which figure his widow had to sell it. “Now this,”
Sir Clifford said, “is the kind of revelling in epi¬
demics which I think is very common in our pro¬
fession.” On March 10 Dr. William Collier of Oxford
opened a discussion at the Medical Officers of Schools
Association on the question, “Ought school-boys to
be allowed to compete in flat and cross-country races
of more than one mile in length?” In the ensuing
discussion Allbutt spoke.

On the death of his former colleague Claudius
Galen Wheelhouse (1826-1909), of Leeds,1 he de¬
scribed his surgery “as the sure practice of an anato¬
mist and craftsman who learnt everything and forgot
nothing; not only so, but of a man whose mind was
so orderly and precise that every detail of that learn¬
ing was continually before his eyes, and standing in
its proper relation to other things”. He graphically
recalled how in 1866 he called him up “suddenly in
the night from his bed, and showed him a young man
with acute pericardial effusion, then in the jaws of
death. All I had to say was: ‘Here is this man dying
of a pericardial effusion. What you have got to do is
to remove it. How you will do it is your affair.’ There
was no time for questions or books, maps or records;

1 Brit. Med. Journ., 1909, i. 985.

SIR CLIFFORD ALLBUTT

191

t he steady hand had to strike, and to strike exactly with 1909
the right weapon and exactly in the right place. This
was done unhesitatingly, and the patient’s recovery,
which began from that moment, was complete.”

On June 8 he lectured on tuberculosis at the Art
Gallery in Whitechapel, and during this month de¬
livered the first half of his FitzPatrick Lectures on the
history of medicine at the Royal College of Physicians,
dealing with “Greek Medicine in Rome”, a subject for
which, though he had long been well equipped, some
further research was necessary. This lectureship ex¬
tends over two years. Though published at the time,
they were further elaborated, and in 1921 brought out
again in a much expanded form, together with other
historical essays, of which the Finlayson Memorial
Lecture (1913) on “Byzantine Medicine”, as carry¬
ing on the historical survey, is specially important.

In the second half of the year he had many public
engagements, and on several occasions argued in
favour of his view that angina pectoris is due to disease
of the first part of the aorta, which, as mentioned
elsewhere (p. 125), he first put forward in 1894. On
July 7 he wrote a friendly letter of congratulation
on an article on “Editorial Revision of Titles of
Medical Papers”, published in the Virginia Medical
Semi-Monthly, sympathizing with the views ex¬
pressed, to Lieut. -Colonel F. H. Garrison, now the
well-known medical historian, who greatly valued
this as the first encouraging note that he ever re¬
ceived from a medical man:

Dear Sir — Thanks for the cutting of your very inter¬
esting paper on Titles. I need not say how cordially I
welcome such an eminent champion of accuracy and pro¬
priety, especially when he occupies so influential a position

192

SIR CLIFFORD ALLBUTT

1909 in this subject as yourself. Medical men contend openly
that any slovenly language will serve for expression, so long
as the writer knows what he himself means! And that even
then an approximate meaning is sufficient. I do not recollect
whence came the quotations you are so good as to cite of
mine; but I dare say you have somewhere near you my
Guide to Composing Scientific Papers (Macmillan).

The references made to Allbutt may be repro¬
duced here: “As Professor Clifford Allbutt puts it,
‘much of the work which is done in our laboratories
and dignified, not improperly perhaps, with the title
of research, much plotting of curves, much watching
of levers and thermometers, nay, not a little morpho¬
logical dissection and cabinet-making, are really little
more than clerk’s work’, for ‘bundles and files of
facts are not science”’. In another part of the paper:
“Professor Allbutt in referring to this inveterate
disease of mistaking words for things thus describes
the relation of the man of science to the material
universe: ‘The watcher, while the stream whirls past,
endeavours to throw labels upon its indefinite and
fleeting parts; some of the labels stick rightly, others
stick in wrong places; others again float along space,
as if attached to something, but signify nothing!’”
Allbutt, as is shown in connection with the Harveian
Oration (1900), the address at King’s College Hospital
(1905), and other instances, modified the title of his
own addresses, so that their final title when published
in book form differed from that when published at
the time of delivery in the medical press.

Although Allbutt and Garrison never met, their
correspondence and common interests in medical
history and literature cemented a transatlantic
friendship.

SIR CLIFFORD ALLBUTT 193

In the last few days of July he attended the 1909
annual meeting of the British Medical Association
at Belfast to open a discussion on angina pectoris in
the Section of Medicine,1 being followed by Sir Lauder
Brunton and Sir William Osier. This statement of
his views was followed by a brief correspondence in
the Lancet on “The Nature of Angina” between the
late Sir Richard Douglas Powell, who dissented, and
Allbutt, who by this time was holiday-making at
Sierre in Switzerland. He always conscientiously pro¬
nounced the word angina, with the quantity which is
periodically shown in the medical papers by scholarly
authorities to be correct, and is as constantly dis¬
regarded. In the discussion at Belfast, Osier bright¬
ened the proceedings by remarking that “when in
the presence of a college don or of a great ‘stickler’
for the proprieties of language he said angina, but
when talking to the ordinary man, he adopted
Horace’s rule and said angina”. Allbutt also joined in
the discussion in the Medical Section on “The Medical
Aspects of Athleticism”, and said that in his experi¬
ence not a single instance of permanent harm from
exercise had ever occurred in young men, except
after some infectious illness, such as influenza. In
October he gave the inaugural address at Charing
Cross Hospital Medical School, where in 1901 he had
presented the prizes, and spoke on two subjects: (a)
the importance of athletic games in the formation of
character; and (b) on the advantages of anatomy as
a disciplinary study and engendering accuracy. On
October 5 he opened a discussion at the Therapeutical
and Pharmacological Section of the Royal Society of
Medicine, with the late Professor A. R. Cuslrny in the

1 Brit. Med. Journ., 1909, ii. 1120.

O

194

SIR CLIFFORD ALLBUTT

1909 presidential chair, “On the Teaching of Therapeutics
in the Hospital Ward”, and pointed out that medical
men must be pioneers and could not afford always
to wait for pharmacologists, though there must be a
mutual watchfulness of each other. Osier, Dyce Duck¬
worth, W. E. Dixon, and R. Hutchison joined in the
discussion. The nineteenth of October found him at
his native place, Dewsbury, opening a new home for
nurses and operating theatres at the Infirmary, and
reviewing the condition of nursing and medical prac¬
tice in Leeds half a century before. On November 25
he spoke again on the subject of angina pectoris, in
a discussion at the Harveian Society. During this
busy year he also gave an address to the Metropolitan
Branch of the British Medical Association on “The
Clinical Aspect of Arterial Disease”,1 and the second
edition of the System of Medicine contained his re¬
vised articles on chlorosis (vol v.) and on over-stress
of the heart, diseases of the aortic area, and func¬
tional disease of the heart (vol. vi.), which were all
expanded and occupied 88 more pages than in the
first edition, especially the article on over-stress, pre¬
viously entitled mechanical strain, of the heart, thus
showing the amount of time and thought devoted
to the revision.

1910

The second instalment of the FitzPatrick Lec¬
tures on Greek Medicine in Rome at the Royal Col¬
lege of Physicians of London and the revision of his
article on neurasthenia in the second edition of the
System of Medicine, which was more than double its
original length, must have fully occupied his thoughts

1 Hospital, London, 1909, xlvi. 433.

SIR CLIFFORD ALLBUTT

195

and spare time; but in spite of this he was active in 1910
many other directions. In February an Advisory
Board to prepare for the Seventeenth International
Congress of Medicine to be held in London in August
1913 was set up, and he was naturally one of this
body. In a letter headed “Duodenal Ulcer and Ap¬
pendix Dyspepsia”1 he supported Mr. Berkeley (later
Lord) Moynihan’s now generally accepted view of
appendix dyspepsia, then a new idea which had been
rather severely condemned by the late Sir Anthony
Bowlby, who thought that one result of Moynihan’s
paper would be that many dyspeptic people would
undergo operations for the removal of the appendix,
and that the great majority of them would be none
the better. Allbutt began his letter: “As I had read
Mr. Moynihan’s paper on ‘Appendix Dyspepsia’ with
much interest, and I fancied that I had learnt yet
one more lesson upon an old text of mine that
‘neurosis’ must be, so to speak, the last ditch of
diagnosis, I felt a little discomforted to read the
severe strictures upon this paper by Mr. Bowlby”.

After a comparison of the views of these two surgeons
and the record of two cases of appendix dyspepsia,
he concluded: “I am disposed to anticipate, then,
partly by the analogies of other such vicious circles,
that a finer discrimination of symptomatic series and
an accumulation of data will prove that latent dis¬
ease of the appendix may not infrequently, in persons
of low resistance, set up reactions of a dyspeptic and
‘neurotic’ kind”. This incident illustrates Allbutt’s
readiness to welcome new ideas, and that as the result
of long experience and a shrewd judgement he hardly
ever made the mistake of supporting a fallacious

1 Brit. Med. Journ., 1910, i. 413.

196

SIR CLIFFORD ALLBUTT

1910 though at first sight promising departure. In the
same issue Professor C. A. Ewald of Berlin wrote con¬
firming the existence of appendix dyspepsia, and
pointing out that he had described these cases in
1899, under the name of “appendicitis larvata, be¬
cause the physician treating them thinks of anything
but a disease originating in the appendix”. Allbutt
followed this up on June 17 by a letter to “The
Times” dealing with the treatment of appendicitis
and the relation of surgeons and physicians in this
connection. On June 11 he was one of the signatories
of a letter to the same paper on the subject of the
feeble-minded.

On June 18 the British Medical Journal brought
out a special number on faith-healing, to which All¬
butt1 contributed the first article, followed by the
late Sir Henry Morris, Mr. (later Sir) Henry Butlin,
Professor William Osier, and Dr. T. Claye Shaw.
This subject and quackery, as well as medical history,
were favourites of Charles Louis Taylor (1849—1919),
who was for more than thirty years on the staff, and
for twenty years (1887-1917) assistant editor of the
Journal ; he and Allbutt were on common ground in
medical history, and on very friendly terms. After
Taylor’s death Allbutt2 wrote: “Many years ago,
when Mr. Hart was editor of the Journal, I had some
conversation on business matters with Mr. Taylor,
and a little later we happened to travel together
abroad for a short time. During this time, unfortu¬
nately, Taylor fell ill, and I was privileged to render
him some little professional assistance, assistance
which, after his manner, he appreciated too gener-

1 Brit. Med. .Jourii., 1910, i. 1453.

= Ibid., 1920, i. 101.

SIR CLIFFORD ALLBUTT

197

ously. Thenceforward our friendship became a closer
intimacy. We corresponded not infrequently, some¬
times on professional matters, more often on literary
and general subjects. When I visited at the offices of
the Association I generally took occasion also to call
upon Taylor. It was one of our little games to test
the correctness of my identification of his anonymous
articles. These were usually so acute, learned, and
witty, that although every now and then one of them
would escape my notice, I was very rarely wrong in
my positive attributions.”

At the annual meeting of the British Medical
Association held in London at the end of July, All¬
butt discussed the late Dr. (later Sir) Frederick
Mott’s paper, “The Nervous System in Chronic Alco¬
holism” in the Pathological Section, and spoke after
James Mackenzie and Lauder Brunton in the discus¬
sion on Professor K. F. Wenckebach’s paper on “The
Effects of Digitalis on the Human Heart” in the
Section of Pharmacology and Therapeutics.

On October 13 he was in Edinburgh to open
the laboratory of clinical medicine at the Royal In¬
firmary; in doing so he deprecated the tendency to
divorce pathology from clinical medicine, and there¬
fore welcomed this laboratory as a step towards their
integration. Two days later he opened the 174th
session of the Royal Medical Society of Edinburgh —
the students’ society — by an address on “Blood-
pressure and Arterial Disease”.

In the autumn he gave the two lectures of his
second year’s tenure of the FitzPatrick Lectureship at
the Royal College of Physicians on “Greek Medicine
in Rome”, beginning with Solanus and concluding
with an account of the pneumatists. As evidence of

1910

198

SIR CLIFFORD ALLBUTT

1910 the extensive preparation for these lectures, atten-
tion may be drawn to his long review1 of Uberg’s
Die U berlieferung der Gynakologie des S or anus von
Ephesus. The lectures, published in the medical
press2 at the time, were subsequently much expanded
and, together with eight other historical essays,
brought out in book form in 1921. In November
he reviewed3 Axon Nelson’s Text und Studien: Die
II ippocr atische Schrift Ilepi, cfrvawv, and included with
this a notice of Ernst Krause’s study of Diogenes of
Apollonia.

1911

In May he contributed under the heading “Energy
and the Organism”4 a pleasantly written review of
Dr. J. B. Hurry’s Vicious Circles in Disease, making
it clear that while the author did not for a moment
pretend to have discovered this notion of vicious
circles he had made it his own, for no one had pre¬
sented the subject systematically in book form,
though many had noticed the sequence, among them
the Teales of Leeds, especially T. Pridgin Teale, who
taught it emphatically in lectures and put it into
practice. With regard to this last point Allbutt
remarked:

Among the absurd axioms which we are apt to repeat
without thought is that which unconditionally impugns the
practical impulse to “treat symptoms”; but in the majority
of cases — in all for which we have no specific antidote— no
other course is open to the practitioner. Moreover, even
where we have such a specific, to refrain from treating
symptoms, if the physician’s is not the patient’s point of

1 Classical Rev., London, 1911, xxv. 49-52.

2 Brit. Med. Journ., 1910, ii. 1398, 1481 ; Lancet, 1910, ii. 1325, 1395.

3 Classical Rev., London, 1910, xxiv. 225.

4 Nature, London, 1911, lxxxvi. 374.

SIR CLIFFORD ALLBUTT

199

view. He asks for cure; but also for relief. Now these observa- 1911
tions and maxims of Dr. Hurry emphasize a further truth—
that in so doing we may be cutting across — at any point, it
matters not where — a “vicious circle”.

In an address on “Arteriosclerosis and the Kid¬
neys”,1 delivered before the Kensington Division of
the Metropolitan Branch of the British Medical Asso¬
ciation, he went fully into the relation of high blood-
pressure and arteriosclerosis and renal disease, and
gave the history of the steps by which he had arrived
at the conception of hyperpiesia or high blood-press¬
ure without renal disease. In April a long and con¬
sidered review on “The Viscosity of the Blood”2 ap¬
peared, in which he summarized existing knowledge
as to “the degrees of dependence of cardio-arterial
integrity upon the qualities of the fluid these vessels
contain and drive”, and concluded that even if esti¬
mation of viscosity is as yet of little clinical assist¬
ance, further investigation should be carried out.
When the late A. D. Waller’s Hitchcock lectures for
1909 at the University of California, Berkeley, were
printed in book form, Physiology the Servant of
Medicine, they were reviewed by Allbutt.3

At the Birmingham meeting of the British Medi¬
cal Association, George Alexander Gibson of Edin¬
burgh (1854-1913) opened a discussion in the Medical
Section, and included in it as entirely coinciding with
his own views the following letter from Allbutt:

St. Radegunds, Cambridge,

July 11, 1911.

Dear Gibson — I fear I shall be unable to attend the
British Medical Association meeting at Birmingham this

1 Brit. Med. Journ., 1911, i. 853, 922.

2 Quart. Journ. Med., Oxford, 1910-11, iv. 342-67.

3 Nature, London, 1911, lxxxv. 465.

200

SIR CLIFFORD ALLBUTT

1911 month. I see you are going to open the discussion on asthma.
^ ou are carelul about language, and I hope you will protest
against the shifting of labels, which encourages loose speak¬
ing and thinking in students and in others. Thus the name
asthma is often used for what is not asthma; for example,
caidiac dyspnoea and uraemic dyspnoea; as slovenly people
talk of uraemic or Jacksonian epilepsy, meaning convulsions
oniv. These ways cause no end of clinical fog and react
unfav ourably on precision of clinical thinking. In a drawing¬
room a lady may call a whale a fish; but to see it so called
in the technical papers of a zoologist would shock us; it is,
however, no worse than cardiac asthma.

This roused James Mackenzie1 to write on October
13 as follows:

Sir Dr. Gibson, in opening a discussion on asthma at
a meeting of the British Medical Association, read a letter
from Sir Clifford Allbutt, in which he spoke of the slovenly
people who use terms without precision, and he singled out
that of “cardiac asthma” as being a particularly repre¬
hensible example. Dr. Gibson states that his views are
exactly those of Sir Clifford Allbutt. As I am one of the
slovenly people who has repeatedly used the term “cardiac
asthma , I would very much like these learned physicians
to tell me where I am wrongf.

To this Allbutt2 replied in conciliatory terms saying
that he had never seen the events characteristic of
spasmodic asthma in cardiac disease; Mackenzie fast¬
ened on this admission and the correspondence be¬
tween them ceased, though Gibson intervened and
carried it on for a short time. Allbutt was apparently
convinced, for in his Diseases of the Arteries, includ¬
ing Angina Pectoris (1915, i. 401) he gave a vivid
account of a paroxysm of cardiac asthma which he

1 Bril. Med. Joum ., 1911, ii. 1010, 1201.

2 Ibid., 1911, ii. 1105.

sin i iiii.mas n.ii ioni) ai i.iii'i r, K.c.n., m.d..

In 1011.

I . It. s.

SIR CLIFFORD ALLBUTT

201

had observed, and compared it to the well-known ion
renal or uraemic asthma, on which he had written in
1877 when it was not so generally recognized.

To Volume XVIII. of the eleventh edition of the
Encyclopaedia Britannica (1911) he contributed an
addendum to J. F. Payne’s article on the History of
Medicine, dealing with Modern Medicine; Payne
(1840-1910) wrote the article on this subject in the
ninth edition of the work, but had been laid aside by
illness for some time before his death on November
16, 1910. It may be noted that this division of labour
was the reverse of that in the article on the history of
medicine in the second edition of Allbutt’s System of
Medicine (1905, i. 1-45), in which he wrote on ancient
medicine and Payne on medicine in Europe from the
beginning of the Dark Ages onwards. Under the head¬
ing “Healing by Touch” 1 he reviewed at some length
Raymond Crawfurd’s book, The King’s Evil. On
August 15 he was at St. Andrews to receive the
honorary degree of LL.D. from the University.

1912

The National Insurance Act 1911, and the way
in which it might affect medical men, gave Allbutt,
who was for four years a member of the Insurance
Acts Committee of the British Medical Association
and thus a spokesman for the profession, a great
deal of work during this and subsequent years. For
the British Medical Association’s Committee he on
several occasions wrote considered statements and
went on deputations to Ministers when important
matters were under discussion. He was also a member

1 Nature, London, 1911-12, lxxxviii. 109.

202

SIR CLIFFORD ALLBUTT

1912 of the Government’s large Advisory Committee of
the National Insurance Act. “The Times” of January
3 contained a vigorous letter from him with the
object of getting the public to realize how the
National Insurance Act must influence the develop¬
ment of medicine; he made it quite clear that the
continuation of a contract method of practice, like
that of clubs, would be most harmful to the well¬
being of medicine, for “in his Insurance Bill the
Chancellor was content with an antiquated notion
of medicine and of medical service; he took for
granted, without inquiry, a notion built of some
vague knowledge of village clubs and of the old-
fashioned vade mecum way of doctoring. This is,
‘For such and such a disease, such and such a drug;
take the mixture, drink it regularly, and get well if
Nature will let you’.” “Gloss it as we may,” he con¬
tinued, “contract practice will stand lower in public
esteem, and will be of lower average efficiency and
much less humane; it will damp the aspirations and
blot the high-minded ideals with which I, who know,
say that the young physicians of to-day are entering
our profession; and it will push them back to old-
fashioned routine and to ill-remunerated and there¬
fore undervalued services.” After this letter the late
Dr. Lauriston Shaw wrote to “The Times” as, in
some degree at any rate, an apologist for the Act.
Allbutt, who in a brief rejoinder described this letter
as a supplement rather than a reply, thus did the
country and the profession a great service by clearly
warning the public that unless the Exchequer and
its Chancellor (Mr. D. Lloyd George) changed their
point of view and amended the actuarial data (based
on an allowance of six shillings a year to the medical

SIR CLIFFORD ALLBUTT

203

man), medicine must be set back or the profession
must refuse to work under the scheme. On Septem¬
ber 22 he wrote a letter1 on behalf of nineteen medical
members of the Advisory Committee of the National
Insurance Act to the Chancellor of the Exchequer,
and later on in the autumn attended a conference
of the Committee with the Chancellor and replied
to his statements.

The first number of the Universal Medical Record
opened with articles by Sir Clifford Allbutt and Sir
Berkeley Moynihan, past and present ornaments of
the Leeds School, on “The Importance of Precision in
Nomenclature” and on “Jejunal Ulcer” respectively.
Allbutt illustrated his theme by the current misuse
of the words “theory” and “fact”, describing
“theory”, that is to say, verified hypothesis, as the
highest mode of scientific or analytical truth, where¬
as “fact” was not any general statement, however
irrefutable, but something known on adequate
testimony to have happened. Further, “by calling
familiar opinions ‘facts’, and novel or unfamiliar
opinions ‘theories’, ideas new but true are swept
into the same heap with visionary speculations,
hazardous suggestions, and arm-chair guesses”. The
word “disease” was too often wrongly used, as if
there were a “morbid entity” which, like an evil
spirit, entered into a man; diseases, he insisted, were
only mental concepts of various disorderly ways of
function and had not any independent existence.
This article was the subject of a leader in the Lancet,
and on April 8, under the heading “The Nomencla¬
ture of Disease” Allbutt wrote a letter2 in defence of
his definition of disease, which had been adversely

1 Lancet, 1912, ii. 911, 1190. 3 Ibid., 1912, i. 1017.

1912

204 SIR CLIFFORD ALLBUTT

1912 criticized by Dr. S. W. Macllwaine. On March 12, in
an address on “The Physician and the Pathologist
on Heart Failure”1 before the Chelsea Clinical
Society at a meeting held at St. George’s Hospital,
he expressed the opinion that the interpretation of
cardiac pathology in terms of clinical medicine had
become less clear than before; this evoked some con¬
tentious correspondence necessitating replies to the
criticisms of a number of cardiologists; chief among
them was Sir Thomas Lewis, who pleaded for time
for the newer school, then investigating the physio¬
logy of the living heart, to give the explanation of
sudden death in a cardiac patient in whom recovery
has been anticipated, and hinted that ventricular
fibrillation might be proved to be preceded by danger
signals capable of recognition. As the Lord Mayor,
Sir Thomas Crosby (1830-1916), was a medical man
it was appropriate that a medical charity — the
British Medical Benevolent Fund — should hold its
annual meeting on March 13 at the Mansion House;
Allbutt attended, and in his speech insisted on the
numerous sacrifices of time and convenience made
by medical men in the course of the discharge of
their duties.

The establishment of the Cambridge Diploma
in Psychological Medicine in May 1912, nine years
before the Royal Colleges in London first granted a
similar diploma, was largely due to his foresight
and efforts. On June 4, during a debate at the General
Medical Council on a recommendation of its Educa¬
tion Committee that the standard of the preliminary
examination before entering the profession should
be raised, he said that the Council would exceed

1 lir it. Mcit. Journ., 11)12, i. 053-59, 862.

SIR CLIFFORD ALLBUTT

205

their duty if they attempted to repair what had 1912
truly been described as the chaotic state of secondary
education in England. When the Royal Society of
Medicine instituted the Section of the History of
Medicine, the late Sir William Osier was the first
President and Allbutt and the late Sir Norman Moore
were among the Vice-Presidents. The Section thus
started with strong support from the three men who
had done most in the country to popularize its
subject.

At the annual Congress of the Royal Institute
of Public Health at Berlin on July 25-28, Allbutt
gave the introductory address to the State Medicine
Section, entitled “The Integration of the Social
Organism”,1 and dealt with the relations between
the individual and the State, with the problems of
heredity, and concluded with an eloquent plea for
the care of children. The British Medical Association
met at Liverpool, and on July 24 in the Section of
Pathology there was a discussion on Bright’s disease,
opened by Professor Lorrain Smith, then of Man¬
chester, and continued by Allbutt’s paper read by
one of the honorary secretaries; he paid special
attention to the cardio-vascular changes and the
relations of granular kidney, pleading for simplifi¬
cation of the nomenclature of the subject, which was
unnecessarily complicated by the use of different
labels for the same lesion.

At the Hospital for Consumption and Diseases
of the Chest, Brompton, he gave a clinical lecture
on “The Relations of Pleurisy to Tubercle”2. On
November 1 Sir Thomas Crosby, who had created

1 Lancet. 1912, ii, 28.1; Journ. State Med., London, 1912, xx. 458.

2 Lancet, 1912, ii. 1485-91.

206 SIR CLIFFORD ALLBUTT

1912 a double record by being the first medical man to
be Lord Mayor of London and by being the oldest
citizen to be elected to that office, invited eighty-
five prominent members of the medical profession
to meet the Presidents of the Royal Colleges of
Physicians and Surgeons at dinner in the Mansion
House, and naturally Allbutt and Osier were present
on this unique occasion.

On November 28 at the General Medical Council
he moved the resolution that “the Insurance Act
Committee [of the Council] be instructed to con¬
sider in the interests of medical education the means
and arrangements under the Act for providing those
aids to diagnosis, treatment, and research which
modern pathology has made available, and be
authorised to make representations to the author¬
ities on these and any other matters arising out
of the Act which come within the functions
of the Council”. After some discussion this was
carried.

1913

For the January number of the Practitioner, which
was specially devoted to the consideration of tuber¬
culosis, he supplied a general introduction.1 In the
same month he wrote a graceful appreciation2 of
the life and work of George Alexander Gibson (1854-
1913), of Edinburgh, concluding: “To me Gibson
was twice a friend, a dear friend in himself, and a
memorial of Gairdner, for in him much of Gairdner
seemed still to live”.

Before the International Historical Congress in

o

1 Practitioner, London, 1913, xo. 1-13.
s Brit. Med. Jonrn., 1913, i. 198.

SIR CLIFFORD ALLBUTT

207

April Allbutt gave an address on “Palissy, Bacon, and 1913
the Revival of Natural Science”,1 in which he dis¬
cussed the probable intellectual relation of Bernard
Palissy (1520-89) to Francis Bacon (1561-1626), and,
in showing grounds for the belief that Bacon was
indebted for inspiration to his senior’s teaching and
museum in Paris about 1576, excused the absence of
any acknowledgement on Bacon’s part by the expla¬
nation that “even so late as the sixteenth century
plagiarism was unknown as a sin, and, by the code
then prevailing, literary debts were not even debts
of honour; even the honest and gentle Pare himself
did not hesitate to borrow freely from the works of
his contemporaries; and when in a particular instance
Pare was reminded that he had drawn freely upon
the work of his contemporary, De Hery, Pare calmly
replied that a candle must always be lit at another
candle”. About this time he reviewed2 under the
heading “A Medieval Physician,” H. P. Cholmeley’s
John of Gaddesden and the Rosa Medicinae (1912).

On June 6 he went to Glasgow to deliver the
lecture founded in memory of James Finlayson(1840-
1906), “a wise physician and a gentle scholar”. Tak¬
ing as his subject “Byzantine Medicine”,3 he showed
that in the domain of science Byzantine thought was
sterile, and that demonism and magic sapped the
foundations of the pathology and therapeutics of that
time and so of the Middle Ages, and led to a super¬
stitious belief in drugs.

When the Medical Research Committee (National

1 Proc. Brit. Acad., 1913-14, vi. 233-47.

2 Nature, London, 1913, xci. 54.

3 Glasgow Med. Jnurn., 1913, N.S., Ixxx. 321-34, 422-39; also in

his (•reek Medicine in Borne, with, other Historical Essays, 1921 on
388-424. ’ ' 1 *

208 SIR CLIFFORD ALLBUTT

1913 Health Insurance) was formed in 1913, Allbutt was
one of the members, and had as colleagues Dr. (later
Sir) Gowland Hopkins and as secretary Dr. (later Sir)
Walter Fletcher, appointed in the spring of the follow¬
ing year, so that with the Chairman, the late Lord
Moulton of Bank, the University of Cambridge was
well represented. Until August 1914 the Committee
met, often weekly, in Lord Moulton’s house, and, as
the minute-books show, Allbutt attended with un¬
broken regularity. On such an important committee
with funds to promote research of all kinds bearing
on health or disease, “whether or not such researches
have any direct or immediate bearing on any par¬
ticular disease or class of diseases”, the advice of a
man such as Allbutt, who had so long been insistent
on the value of research carried out upon sound lines,
was invaluable. Sir Walter Fletcher wrote: “He greatly
aided the original Committee in forming the general
design of having a limited scientific staff of their own
in a central institute, while reserving the greater part
of the available funds to assist work all over the
country, either initiated by the Committee or pro¬
posed to them by the workers themselves”. During
the War he was most useful in helping the policy of
segregating particular diseases for expert treatment
in special centres, which became an accepted prin¬
ciple before the end of the War. His retirement from
the Committee in August 1916 was characteristic of
him; there was not any regular retiring rule, but
though he was taking a most active part in the work
and desired to continue to do so, he felt that some
rotation in the membership was the right course, and
accordingly, as the oldest member, led the way.
Sir Walter Fletcher in supplying this information,

209

SIR CLIFFORD ALLBUTT

adds: “though the oldest in years, he had one of the 1913
youngest minds of them all”, and that he kept in
constant touch with the Committee and Council, as
it became in 1919, until his death. On November 23
he wrote to Professor W. S. Thayer:

My delay in reply does not suggest to you the pleasure
I always find in seeing or hearing from you, but I have been
very heavily engaged in work the last three months, and
still am. Among other things I am on a small sub-committee
for using £57,000 a year in Medical Research for the English
Government. We are starting a Research Hospital and hope
also to subsidize good workers wherever in Great Britain we
can hear of them. The addition to my language file is duly
inserted. I am to re-edit it when I can, but I have a big book
on Arteriosclerosis and Angina Pectoris in the press. This
is a very egotistic letter. Some day punish me by telling me
more and more about yourself.

In August, just before the meeting of the Seven¬
teenth International Medical Congress in London, he
attended the Fifth Annual Conference of the National
Association for the Prevention of Tuberculosis, which
was opened by the Prime Minister (H. H. Asquith),
in spite of interruptions by suffragettes, at the Cen¬
tral Hall, Westminster. Allbutt spoke in the discus¬
sion of Sir Robert Philip’s paper on the “Co-ordina¬
tion of Antituberculosis Measures”, and incidentally
pointed out that tuberculosis, like other diseases, was
not a definite thing, but an abstraction or a mental
conception of the reaction produced by the morbid
process.

In the September number of the Classical Review 1
he reviewed J. L. Heiberg’s “Pauli Aeginctae Libri
tcrtii Interpretatio Latina antiqua adjuvante Insti-

1 Classical Rev., London, 191;], xxvii. 207.

P

210

SIR CLIFFORD ALLBUTT

1913 tuto Puschmannio Lipsiense” (1912). In this year he
received the honorary degree of D.Sc. from the Uni¬
versity of Durham, and was appointed a Visitor of
Medical Schools under the Board of Education.

1914

On January 16 he attended the annual dinner of
the Royal College of Physicians of Edinburgh, and,
together with the late Sir William Turner, pleaded
eloquently on behalf of the proposal to establish a
Research Institute as a memorial to Lord Lister.

The Family Encyclopaedia of Medicine, brought
out by the Harmsworths on February 26, contained
articles over the names of Allbutt, Osier, and other
Fellows of the Royal College of Physicians of Lon¬
don. By what in the medical press was described as
“a blazing indiscretion”, the Encyclopaedia, with the
names of the authors, was glaringly advertised in the
pages of the lay press. This contravened a Resolution
of the College, dated February 2, 1888:

That it is undesirable that any Fellow, Member, or
Licentiate of the College should contribute articles on pro¬
fessional subjects to journals professing to supply medical
knowledge to the general public, or should in any way
advertise himself, or permit himself to be advertised in such
journals.

Accordingly the Censors’ Board drew the attention
of those thus advertised who belonged to the College
to this resolution. A meeting of the medical men con¬
cerned was held, and it appeared that they were in
no way responsible for what had occurred and that
they had merely read and corrected, at the request
of a medical man engaged on a book on domestic

SIR CLIFFORD ALLBUTT 211

medicine, certain articles. Osier, as is set out in 1914
Cushing’s Life,1 took the attitude of the Censors’
Board and the College very seriously, and as a pro¬
test sent in his resignation of the Fellowship, which,
however, he was induced to withdraw. Allbutt ap¬
pears to have treated the incident with philosophic
calm.

After a fly-sheet warfare, the Senate of the Uni¬
versity of Cambridge on March 14 approved, by 267
votes to 235, a majority of 32 only, the proposal of
the special Board for Medicine to apply to the Board
of Education for a grant to the Medical Department,
on the ground that without immediate help of this
kind it would be impossible to maintain the reason¬
able efficiency of the manifold departments of science,
elementary and applied, which are essential parts of
a great school of medicine. The fear expressed by the
opposition that the acceptance of such a grant would
put university teaching under the control of a Govern¬
ment Department eventually proved to be baseless,
as indeed was prophesied during this discussion. A
week later the two-day annual meeting of the Asso¬
ciation of Physicians of Great Britain and Ireland
was held for the first time in Cambridge, and Allbutt
was the President. This body, limited to 250 ordinary
members, was founded largely as a result of the late
Sir William Osier’s energy, and one of its rules runs:

No reporters shall be present, and no report of the
proceedings shall be sent to the journals or news¬
papers . Members receive the Quarterly Journal of
Medicine, which was started at the same time and
closely connected with it. The Journal contains a
brief record of the business and scientific proceedings

Cushing, IT., Life of Sir W. Osier, 1925, ii. 398.

212

SIR CLIFFORD ALLBUTT

1914 of the annual meetings. Before the thirty-sixth meet¬
ing of the Royal Commission on Venereal Diseases
Allbutt gave evidence mainly on the arterial lesions
which were responsible for probably 95 per cent, of
the aneurysms, and might be prevented by early
treatment on the most modern lines.

On May 25 he gave the Linacre Lecture at St.
John’s College, Cambridge, on “Public Medicine and
Hospitals in Ancient Greece and Rome”, which he
published, under the altered title of “Public Medical
Service and the Growth of Hospitals”, together with
other historical essays, in his volume Greek Medicine
in Rome (1921). This Linacre Foundation, dating
from 1524, is the oldest medical lectureship in the
University, for the Regius Professorship of Physic
was not established by Henry VIII. until 1540. The
lectureship did not fulfil the pious founder’s inten¬
tions and became a sinecure, being held by a resident
fellow, often for long periods, and not always a medi¬
cal one, for example, Matthew Prior. Among the Lin¬
acre lecturers William Heberden the elder, Thomas
Watson, John Ilaviland, and George Paget stand out
as particular stars. In 1908 a new arrangement was
made whereby the appointment was held for one
year only, it being “decided to invite annually a man
of mark to give a single lecture on the same general
plan as the Rede Lectureship” in the University, also
founded in 1524. The first lecturer under this new
dispensation was the late Sir William Osier, who de¬
voted his lecture to a sympathetic consideration of
the scholar-physician Thomas Linacre, and in 1913
the late Sir Norman Moore spoke of “The Physician
in English History”. So, in the course of live years,
three scholar-physicians who had done so much in

SIR CLIFFORD ALLBUTT 213

stimulating the study of medical history in this 1914
country were Linacre lecturers. In the following year
the late E. H. Starling gave the lecture on “The Law
of the Heart”.

In September, after the outbreak of war, he was,
with other leading scientific medical men, one of the
signatories of a letter urging the compulsory vaccina¬
tion against enteric fever.1 Early in the year, at a
meeting of the governing body of the Lister Institute,

Lord Iveagh proposed that the Institute and all its
resources should be handed over to the nation as the
headquarters of national medical research, and most
generously offered to build a hospital in the immedi¬
ate neighbourhood of the Institute, so that the In¬
stitute and the attached hospital should take the
place of Mount Vernon Hospital, which the Medical
Research Committee had already acquired. This pro¬
posal, though recommended by the governing body
on the report of a special sub-committee, was vigor¬
ously opposed by some of the most influential mem¬
bers, and eventually was dropped. The rather ex¬
tensive correspondence on the pros and cons in¬
cluded a long letter dated November 30 from All¬
butt,2 who was definitely in favour of the amalgama¬
tion of the Lister Institute with the Medical Research
Committee.

1915

On the death of his colleague Howard Marsh, the
second and last professor of surgery in the Univer¬
sity, and Master of Downing College, Allbutt wrote
an appreciation,3 saying: “Our first thoughts will be

1 Brit. Med. Journ., 1914, ii. 4815. 2 Ibid., 1914, ii. 997.9s

3 Ibid., 1915, ii. 97.

214

SIR CLIFFORD ALLBUTT

1915 of the man; our thoughts of the Professor and the
Master will come in the second place. Howard Marsh
was a man of warm and generous affections, and
these were so natural to him that he was as little
self-conscious of his own goodness of heart as of his
five senses.”

During the war Allbutt undertook many new
duties, becoming an honorary Colonel, Eastern Divi¬
sion R.A.M.C., and thus doing much advisory work,
besides taking up regular duty in the wards of Adden-
brooke’s Hospital when the staff was depleted and
overworked. But he did not relax his literary activi¬
ties. In June he reviewed1 Hermannus Wagner’s in¬
augural dissertation (1914) on the question whether
or not the treatise on the “Beginning of Life” is
rightly ascribed to Galen, and agreed with the author
of the dissertation in rejecting this view. The Practi¬
tioners' Encyclopaedia of Medical Treatment (1915),
edited by W. Langdon Brown and the late J. Keogh
Murphy, both Cambridge graduates, was dedicated
to the two Regius Professors, Osier and Allbutt. It
began with an introduction of five pages by Allbutt,
who mentioned that it was written “on a mountain
in Switzerland far away from books and papers”, and
so presumably some time before the outbreak of war.
In September an article on “The Value of University
Training as a Professional Asset”2 appeared from his
authoritative pen, and on December 11 he paid a
graceful tribute3 to his old friend C. A. Ewald of
Berlin.

His great work on Diseases of the Arteries, including

1 Classical Iicv., London, 11)15, xxix. 115.

2 Practitioner, London, 1915, xev. 2S2.

2 Lancet, 1915, ii. 1372.

SIR CLIFFORD ALLBUTT

215

Angina Pectoris (2 volumes, pp. 534 and 559), which 1915
he had long been engaged on and contained the gist
of many papers and addresses, including the Lane
Lectures at San Francisco in 1898, appeared when he
was in his eightieth year, thus recalling Morgagni,
whose De Sedibus et Causis Morborum (1761) also
came out when the author had completed fourscore
years. In these two volumes Allbutt brought together
his mature conclusions on hyperpiesia, often called
by others essential hypertension, on which he had
written since 1895, on angina pectoris, the aortic
origin of wrhich he had advocated from 1894, and on
arterial blood-pressure, the estimation of which was
in great measure due to his influence. After such an
effort many would have been content to let the sub¬
ject alone, but not so Allbutt, for he published a
number of papers on these subjects in the remaining
ten years of his life, and left behind him a book of
some hundred pages, Arteriosclerosis: A Summary
View (1925). A good example of his fine and polished
style is to be found in his introduction to the subject
of angina pectoris ( Diseases of the Arteries, including
Angina Pectoris, ii. 211):

In this secret and fell disease there is a fascination to
which no physician is a stranger, a fascination in its dramatic
events and in the riddle to be read. By angina pectoris the
humble out-patient is for the nonce lifted up into the sphere
of a Hunter or an Arnold; over him we endeavour to bring
the old discordant and mutually destructive arguments into
some consistency, ringing again the old changes on the old
bells. I too am content to compose another tune on the old
chime: still, I have the excuse, at least to myself, of an
independent endeavour, if not, as I diffidently hope, to
solve the old problems, yet at least to elucidate them by
compelling our nomenclature, our technical terms, and our

216

SIR CLIFFORD ALLBUTT

1915 current phrases to declare themselves each for what it is
worth; and, no longer drifting hither and thither about the
nosological field, to compel them to take up each its own
rank, and no other than its own rank, in the argument. In
this Section, therefore, some controversy is unavoidable;
and as I must withstand adversaries better equipped than
myself, I fear lest what Jurine said of Parry may be said
of me, II nous semble que M. le Docteur a moins manqu6
d ’indulgence pour lui-meme que pour ses collegues”. I would
not forget Harvey’s saying: “Concordia res parvae crescunt,
discordia magnae dilabuntur”, but I want the concord on
my own side.

1916

In March, together with other colleagues at
Addenbrooke’s Hospital, he published a case of
chronic splenic anaemia much improved by splenec¬
tomy,1 and on May 6 he and Sir William Osier2 wrote
a long letter urging medical men to give their much-
needed services to the Navy and Army. On May 11
he contributed to Nature an appreciative review3 of
Harvey's Views on the Circulation of the Blood, by
the late Professor J. G. Curtis, of Columbia University,
in which he touched on the relation between the views
of Aristotle and Harvey and on the “innate heat”;
the latter subject lie expanded in his article for the
collection of Contributions to Medical and Biological
Research, dedicated to Sir William Osier in Honour of
his Seventieth Birthday, 1919. It may be noted that
Osier also reviewed Curtis’s book, in the Lancet
(1916, i. 416). Allbutt recorded, with a pathological
report by Professor II. M. Turnbull of the London

1 Allbutt, C., Humphry, L., Heighten, F., and Hare, D., Brit.
Med. Journ., 1910, i. 365.

2 Lancet, 1910, i. 972.

3 Nature, 1910, xcvii. 217.

SIR CLIFFORD ALLBUTT

217

Hospital, a case of syphilitic disease of the aorta.1 1916
As a member of an Advisory Committee of the
National Insurance Act, Allbutt, with others, had
been successful in obtaining a large increase in the
payment made to medical men; this he mentioned
in a letter2 dated September 14, 1916, pointing out
in leply to letters and appeals in the medical press
that, except as a member of the large Advisory Com¬
mittee, he had not had anything to do with the
initiation, general provisions, or workings of the Act.

In July he wrote two separate appreciations3 of
R. W. Michell (1860—1916), the medical authority,
guide, and friend of rowing men at Cambridge, who
died in France from the effect of shell wounds received
while carrying in wounded from the firing line. Michell,
as already mentioned, had provided a special section
dealing with the effect of hard physical exercise on
the heart of young men in Allbutt’s article on “Over¬
stress of the Heart” in the second edition of his
System of Medicine (1909, vi. 193-252).

^ On September 7 the Educational Supplement of
‘‘The Times” contained a letter, under the heading
“Classics versus Science”, from him sternly indicting
the teaching at the Public Schools, and declaring that
the average young man comes up to the University
with his mind empty of all scholastic knowledge,
classical and scientific, and without any command
of English. As he had said before, “the science we
need is a scientific method of teaching all things”.

I his letter brought him much correspondence and
requests for an illustration of “the scientific method
of teaching all things”; to these he replied at some

1 Lancet, 1916, i. 1033.

3 Brit. Med. Journ., 1910,

218

SIR CLIFFORD ALLBUTT

1916 length on October 15, saying that “all schoolmasters
should be imbued equally with the humane and the
scientific habit of mind”, that “we need science in
our classics as we need humanity in our science”,
and that “for English boys the concrete must come
first, the abstract afterwards, a lesson they try to
teach their masters; yet in customary classical teach¬
ing the boy is started upon remote and subtle abstrac¬
tions”. In a third, and the longest, letter on November
16, he pointed out that the scientific method is to
combine demonstration of the concrete with the
abstract, and thought that Baden Powell’s method
of teaching boy scouts illustrated the right way of
doing this; that in teaching Latin and Greek these
languages should be used as means of communica¬
tion; and that to regenerate all teaching by the
scientific method is much more important than the
inculcation of special sciences. These three letters
were afterwards published in pamphlet form.1 In July
of the next year he followed the subject up by a
letter to the Educational Supplement of “TheTimes”,
in which he instanced the case of not a few evidently
good men who, although they did their paper work
well in the Cambridge 1st M.B., having learnt their
subject by heart, often failed utterly in the practical
work because they had not had the opportunity of
previously carrying it out.

In his obituary notice in the Proceedings of the
Royal Society of Sir Thomas Lauder Brunton (1844-
1916), who died on September 16, 1916, in the middle
of the war, Allbutt wrote: “It appears that, for
some years past, from his intimate knowledge of the
German people, Brunton had foreseen their propen-
1 Science in the School, 22 cm., Cambridge, pp. *20, 1917.

SIR CLIFFORD ALLBUTT 219

sity, sooner or later, to force a war upon this country.
He feared, however, that we should never submit to
conscription, unless possibly in a crisis such as the
present. For this reason, and in furtherance of his
scientific work on hygiene and dietetics, he founded
the ^National League for Physical Education and
Improvement, an organisation devoted to the nurture,
from infancy upwards, of a healthy, vigorous, and
high-spirited people. The League, it is to be hoped,
is now so far established in the public favour and
interest as to survive the loss of its leader. The
fulfilment of its purpose would be his most signal
memorial.”

From November until the early weeks of 1917
there was a somewhat vigorous correspondence in the
Bt itish Medical J ouvnal on the perennial question of
the fees of physicians and surgeons. It began by the
following quotation from a letter of Sir Lauder Brun-
ton: “The whole question of the remuneration of the
medical profession and of its various branches will
naturally give rise to much discussion. For example,
I have of late years frequently been consulted in re¬
gard to abdominal operations. The question, Shall
an operation be performed or not? has been left
entirely in my hands, and on the correctness of my
answer the life of the patient has depended. Yet for
my advice I received the fee of three guineas. If an
operation was necessary, the surgeon received a hun¬
dred guineas.” The late Dr. Charles Mercier wrote
suggesting that a physician on the consulting staff
of a hospital should charge five guineas for a con¬
sultation and ten guineas for one lasting an hour,
and by referring to physicians as the higher branch
ol the profession, stimulated surgical and other corn-

1916

220

SIR CLIFFORD ALLBUTT

1916 ment, to which he gleefully responded. Sir Clifford
entered into the “antique, if not ancient,” contro¬
versy which, he said, had returned in the somewhat
sordid guise of a battle of fees, and attempted to
raise the discussion to a higher level by reverting to
the artificial separation of medicine from surgery,
which he had fully set out in his address at the St.
Louis Congress in 1904 on “The Historical Rela¬
tions of Medicine and Surgery to the end of the
Sixteenth Century”. “How long”, he asked, “are we
to go on, as by a Solomon’s schism, cutting mala¬
dies in halves and distributing one moiety to one
professor, the other to another, without laughter or
tears?”1

On December 9 he gave an address 2 to the annual
meeting of the North Staffordshire Medical Society
on “The Work of the National Medical Research
Committee”, from which he had just retired, having
been an original member in 1913. The history of the
establishment of this Committee and of its activities,
which had naturally been so much disturbed by the
outbreak of war, was set out and showed “the in¬
tense vitality of the movement and of the army of
workers”. It expressed his belief that “in the next
twenty years, as in the last twenty, medicine will
be so enlarged and illuminated in many directions
that the art and science will be again transformed.
And upon these new conceptions, new discoveries,
and new auxiliaries will be based a new therapeutics
to give us a command over disease as great again
as that ascendancy which already has distinguished
our own generation.”

In 1916 the War Office and the Medical Research

1 Bril. Med. Journ., 1916, ii. 855. 2 Ibid., 1916, ii. 785.

SIR CLIFFORD ALLBUTT

221

Committee established a special hospital for dis- 1916
orders of the soldier’s heart at Hampstead, where
Dr. (now Sir) Thomas Lewis was a whole-time worker,
and Allbutt, Osier, and James Mackenzie were
appointed as an Advisory Committee and consultant
physicians; in 1917 it was arranged that cases from
France should be sent direct to the hospital and not,
as hitherto, indirectly through hospitals in this
country. In the autumn of that year the clinic was
transferred to the Military Hospital at Colchester,
where there was a team of keen workers, including
American medical officers, such as B. S. Oppen-
heimer, M. A. Rothschild, and S. A. Levine, speci¬
ally interested in cardiology. A great deal of the
valuable work done here was published. The consult¬
ants paid visits to the hospital; a distinguished
American physician writes about Allbutt: “I treasure
the memories of his visits. He always seemed so
gentle, and it also seemed as if he was particularly
courteous to the early Americans who were attached
to the Hospital”. This was no one-sided or a tran¬
sient feeling, for in reply to a letter from Dr. S. A.
Levine raising the question of the relation of angina
pectoris and auricular fibrillation, Allbutt wrote on
September 24, 1922: “I am pleased to receive your
letter, indeed anything to remind me of my former
colleagues at Colchester is more than welcome. I
was delighted to find them there, and before at
Hampstead; they were ‘live wires’. I am gratified
by your cases now mentioned and the pamphlet,
because I have just been, and am, in correspondence
with James Mackenzie herein, and he has sent me
some cases to discuss with him.” On January 29,

1925, shortly before his death, he wrote on receipt

222 SIR CLIFFORD ALLBUTT

1916 of a monograph on the surgical treatment of mitral
stenosis:

My dear Dr. Levine— It is nice to receive a greeting
from you. The pamphlet came just before I was to lecture
(I did so) on mitral stenosis. So I handed the book round the
class and thence it goes on the table of our Medical School
Library. It is a bold enterprise, but so was ovariotomy, as I
too well remember. All well herein. Our best wishes to you
and yours. — Yours very sincerely,

Clifford Allbutt.

When a new word seemed desirable for the con¬
dition described in military nomenclature as “dis¬
ordered action of the heart” (D.A.H.) and now known
as “effort syndrome”, Sir Clifford was consulted and
wrote to Sir Walter Fletcher:

The ancients would have used the word TraX^uos. I have
not looked up other words as I feel pretty sure that this was
the proper word in the best (Hippocrates’, etc.) time, and
if you wish, as presumably you do, to bring in prominently
the neurotic side, neuropalmos, or to coin a word neuropalm-
osis (I think the form TrdXfiajcns does not exist, but it is quite
a legitimate form, and would mean neurotic pulsation). This
leaves out the dyspnoea and also effort (novos) of course, but
one cannot get it all in.

Two days later he wrote a card to say: “You may
prefer to omit neuro- in favour of effort and thus get
ponopalmosis”.

In this year he reviewed1 at length three com¬
mentaries of Galen edited by J. Newaldt, G. Helm-
reicli, and J. Westerberger (1914).

1 Classical Rev., London, 1916, xxx. 84.

SIR CLIFFORD ALLBUTT

223

1917

The question whether or not to maintain Greek 1917
as a compulsory subject in the Previous Examina¬
tion at Cambridge, which had been debated in 1880
and 1891, came up again in 1904 and subsequent
years until the question was finally decided by mak¬
ing Greek optional on January 17, 1919. With his
keen interest in educational problems, Allbutt took
an active part in the debates and signed several
memorials to the Council of the Senate during the
prolonged discussion on this subject. On February
28, 1917, he signed a memorial expressing “dis¬
appointment that the Council of the Senate, while
recording their opinion ‘that the question of com¬
pulsory Greek is one of practical urgency at the
present time’, have yet decided to take no immediate
action with regard to its position in the Previous
Examination. It is now generally recognized, even
by those formerly in favour of compulsion, that, in
the altered circumstances of the Nation, Greek must
be made optional. We believe that to delay in this
matter till the war ends will probably inflict grave in¬
jury on the future of the University, and on the educa¬
tional welfare of the country as a whole. We respect¬
fully ask the Council to reconsider their decision”.

This question was also under consideration at Oxford,
where, after Greek was maintained as a compulsory
subject in Responsions on June 17, 1919, a statute
abolishing compulsory Greek in this examination,
which corresponds to the Previous, was approved by
Convocation by 434 to 359 votes on March 2, 1920.

In the Medical Press and Circular (1917, N.S.,
ciii. 199), under the heading of “Letters to Eminent

224

SIR CLIFFORD ALLBUTT

1917 Persons”, which somewhat resemble the “Inter¬
cepted Letters ’ written in the Lancet a hundred
years ago by James Wardrop (1782-1869), there
was a laudatory but at the same time not very re¬
spectful one addressed to the Regius Professor of
Physic at Cambridge over the signature of “Cer-
ceris . It contained an attack on the Royal College
of Physicians of London, and in addressing Allbutt
as a happy combination of the scholar and man of
the world, learned but cosmopolitan, urbane but
detached and dignified, said that this note of de¬
tachment enabled him “to be Censor of the Royal
College of Physicians without becoming in any de¬
gree soiled by the soot of snobbery which hangs like
a pall over Pall Mall East to concentrate, ever and
anon, in comic negro minstrelsy upon the Censors’
Board. They never made you their president, these
paltry panjandrums,1 because they dared not.”
This raises the question why neither Allbutt nor
Osier was elected President of the College. That
Osier was not unthought of is shown by his letter
to a Fellow of the Royal College of Physicians in
January 1915, when Sir T. Barlow was approaching
the end of the usual five years as President and con¬
sideration was naturally being given to the selection
of his successor, who turned out to be the late Sir
Frederic Taylor, elected on Monday March 28, the
day after Palm Sunday. Osier2 wrote: “I think the

1 The word “panjandrums” was applied by Dr. Leonard Williams
to the members of the Censors’ Board (vide Med. Press and Circ.,
1910, N.S., eii. 463), and was of course taken from the nonsense lines
constructed by Samuel Foote (1720-77), actor and dramatist, in order
to test the statement of old Charles Macklin (1G97?-1797), the actor,
that he could memorize anything by hearing it once.

1 Life of Sir William Osier, by Harvey Cushing, 1925, vol. ii. p.462.

SIR CLIFFORD ALLBUTT

225

President of the College should be a man resident in 1917
London. I have had enough of these things and am
not especially ambitious in this direction. To tell
you the truth, I think the business would bore me
to death. All the same, it is awfully good of some of
the Fellows to think of me.” Although documentary
proof is not forthcoming, it was certainly felt before
the War by some Fellows that Allbutt should be
President, if only for one year. The real reason why
no Fellow resident away from London has, at any
rate for two and a half centuries, been elected Pre¬
sident of the College is the amount of business which
falls on the President and really necessitates almost
constant attention. This is perhaps fully realized
only by those who have occupied the chair and by
the permanent officers of the College. It takes a new
President some months to get into the routine and,
as continuity is obviously desirable, this considera¬
tion must have weighed against election for a year
as a desirable tribute to such outstanding person¬
alities as Allbutt and Osier. It is true that Francis
Glisson (1597-1677), who was Regius Professor at
Cambridge from 1636 to 1675 when he was obliged
to appoint Dr. Brady as his deputy, was President
of the College from 1667 to 1670, but the demands
made by these two offices then were slight as com¬
pared with those at the present time, and it would
appear that Glisson lived a good deal in London. On
the other hand at the Royal College of Surgeons of
England a country Fellow, Sir Berkeley (afterwards
Lord) Moynihan, was elected President in 1926, and
Leeds is much further than Cambridge from London.

In the Classical Review he wrote a long notice of
Galen’s Natural Faculties, translated by Dr. J. A.

Q

226

SIR CLIFFORD ALLBUTT

1917 Brock for Loeb’s Classical Library (1916). In August
Allbutt was in the Lake District at Ullswater and
writes to Lieut. -Colonel F. H. Garrison: “Just a card
to acknowledge your pleasant letter and the an¬
nouncement of the second edition which you are so
good as to propose to send to me. You may well be
busy.”

In the second half of 1917 there was a volumin¬
ous correspondence in the Lancet, evoked by Dr.
G. A. Sutherland’s Lumleian Lectures at the Royal
College of Physicians of London on “The Modern
Aspects of Heart Disease”, in which James Mackenzie
and Allbutt were prominent protagonists, two of
Mackenzie’s letters occupying four columns and All¬
butt responding with four and two and a half
columns. In one of these letters, under the heading
of the “Lumleian Lectures and Medical Research”,
Allbutt1 said that he was replying to Mackenzie’s
criticism of “the Old School” (which he presumed in¬
cluded himself) who reasoned from clinical rather
than from experimental data. This correspondence
between two friends, Mackenzie in private letters
sometimes addressing Allbutt as “My dear Master”,
for example, in a letter now in the Royal College of
Physicians’ collection of autographs, recalls their
correspondence in the pages of the British Medical
Journal in 1911 on the subject of cardiac asthma
(vide p. 151).

The Reverend K. Jameson, Vicar of the Church
of St. Edward the King, just behind King’s Parade
in Cambridge, encouraged laymen to give occasional
addresses to his congregation. On Sunday, November
11, the church was crowded to hear Allbutt preach;

i Lancet, 1917, ii. 172.

227

SIR CLIFFORD ALLBUTT

and of this sermon the vicar wrote: “The memory of
it will persist in that audience. It was a statement of
the reasonable faith of a scientific man. In the simple
language of clear thought, and with his own inde¬
scribable charm of manner, he traced the lines of
thought and feeling along which he himself had
gradually arrived at that faith, and in that sermon
were united the essences of a severe thinker and a
great gentleman.”

This seems to be the first of several similar ser¬
mons in subsequent years delivered in Leeds, Dews¬
bury, and Cambridge, which will be noted later. All¬
butt was humble and deeply religious, but so reticent
m this respect that many who thought they knew
lnm well had not any acquaintance with this side of
Ins life. Though bred up in the atmosphere of the
lurch, his early years of manhood and impression¬
ability were characterized by much controversy on
the relations of religion and science, stimulated by
the appearance of Charles Darwin’s Origin of Species
(18o9) But, in spite of the difficulty, greater then
than before or since, and of his eminence in medical
science, which has so often exerted an influence in
the direction of materialism and agnosticism he re¬
mained unshaken in his faith. Those who knew his
religious convictions will probably agree with the
description, given in Archdeacon J. W. Hunkin’s
sermon on March 1, 1925, that “among the religious
he stood for scientific method: among scientists for
re lgious faith ’, and that “no man ever came nearer
to the ideal of what a Regius Professor of Physic
should be in a University like this”. He was a frequent
communicant in Caius College chapel on Sunday
mornings, was a great-souled man with much

1917

228

SIR CLIFFORD ALLBUTT

1917 spiritual experience, and fond of the text “living in
the courts of the Lord” and all it implied, but withal
he seemed at times something of a mystic. Bishop
Talbot wrote of him as one “who with his great
scientific strength combined, and was at pains to
show that he combined, a strong and simple faith in
the Divine ordering”.

His interest in theological questions is shown in
the following letter (December 14, 1922) to Professor
J. F. Bethune-Baker, who had sent him some exposi¬
tions of Troeltsch’s ideas by F. von Hugel in re¬
sponse to an inquiry:

Many thanks for von Hiigel’s tract. I have read it several
times over; it is a hard nut to crack — if indeed I have
cracked it. It is magnificent rolling rhetoric, and at the end
one asks oneself how much more it may be. The “manner”
is splendid, what of the matter? And here I am referring
both to von Hugel and Troeltsch. One principle is no doubt
the vindication of the internal spontaneity of the Christian
idea, as contrasted with exclusive use of the New Testament.
Another is the esteem of personal values, the consummation
in what I would call Person, not “personality” a vague
abstract term. There is a curious medieval turn, or even
core, in many paragraphs. And he relies on the, to me,
empty word “Absolute”— which surely consists only in a
sum of negations. You will think Einstein a very arid pro¬
phet, but I admit that I owe much to him, especially in
the “time dimension”; which makes, I think, for the spiritual
side of creation; time being a form of thought, and probably
only a mode of human thinking. Many years ago I got into
a scrape with Swete and others for urging the relativity of
all human cosmic argument, in an address to his ordination
candidates. Many years before that I had felt this when as
a passenger observing the relative motions of two trains
passing along parallel lines but at different speeds. It seems
to me that only by Einstein can we get rid of Copernicus

SIR CLIFFORD ALLBUTT

220

and the geologists! But I am taking advantage of your good 1917
nature and must shut up.

On another occasion, dealing with the relation of
conduct to popular opinion, he deprecated any at¬
tempt to seek the favour of others and went on to
show that the only course was: “to work with the
Holy Spirit, as fellow workers; and if we do this, and
oftentimes a day (if but momentarily), we lift up our
hearts, the light shines within, and we feel at least
near us, the peace which passeth all understanding.

I never take to the adorative adjective ‘Almighty’ —
but believe the Spirit of God is working out his pur¬
poses under conditions (unknown to us), and we are
fellow workers with him, towards perfection some¬
how and somewhere.”

Allbutt was much in sympathy with the Society
of Friends, as is shown by a letter dated July 27,

1924, to a member of the Society of Friends, in which
he wrote:

If I had a fresh start in life, I should be of your body;
you are nearer Christ than any other communion. Acton
used to say “How can I leave a church in which I was
born, baptized, and married, and with which all my life has
been inextricably bound up — tendrils everywhere”. So I feel
in and with the Church of England, distressing as is the tide
of superstition and sacerdotalism which is now flowing over
it. Happily there are more than “ten thousand” of us who
will not bow down to this Baal! You have probably for¬
gotten that once — when I was going on to a meeting of the
Archbishop’s Faith Healing Committee — you said to me, as
a last word, coming from above as I descended the stairs —
“Remember God always answers prayer, though it may not
be in the way we looked for”. For years I had prayed and
yearned for “a sign”— a touch — a vision — if only one. It
never came; I was never pure enough; but since your words

230

SIR CLIFFORD ALLBUTT

1917 I have found it in a general uplifting and interpenetration
of my life by the indwelling Spirit. ... I often go — or went;
my deafness in public meetings now discourages me — to
Quakers’ meetings. Even still, if I don’t hear, the very air
is aglow with the Spirit — and the people so humane and
friendly. Perhaps it is best when some plain homely man or
woman speaks to us. And yet — one is sadly shaken by what
must be the deeds of an Evil Spirits I am more than half
Manichaean.

The same sympathy with the followers of George
Fox (1624-91), “the Founder of Quakerism”, is
shown in the following letter written to the same
friend on May 15, 1921:

St. Radegunds, Cambridge.

An occasional “Friends’ Quarterly” is very welcome. It
was hardly possible to tackle the volume of appreciations of
Keats which descended from the critical firmament upon us,
and I was thankful tranquilly to read yours, which I am
sure gave me all that the rest contained, of vision and
essence. The Cambridge Platonists have always interested
me much; and the article on Henry More was also good
reading. It is not easy to judge between dedication in the
world, and dedication out of the world; with cloistered virtue
I am less in sympathy, and am no doubt faulty in this
respect. But the Friends seem to me to solve the difficulty;
the soul is carried into the workaday world. Like Jesus
Christ, they receive publicans and sinners and eat with them.
I can never quite get over the superfine dedication of
Thomas a Ivempis, who says that he never went out into
the world without bringing back a stain on his soul.

SIR CLIFFORD ALLBUTT

231

1918

At this time Allbutt became the first President of 1918
the Papworth Village Settlement for tuberculosis.
After his death a fund was collected for the erection
of two cottages — the Clifford Allbutt Memorial Cot¬
tages, which were declared open on May 18, 1928,
during a visit of the Prince of Wales. The memorial
stone on the cottages reads as follows:

ERECTED

to the
Perpetual
Memory
of

THE RIGHT HON. SIR CLIFFORD ALLBUTT,

K.C.B., M.D., F.R.S.,

Regius Professor of Physic in the
University of Cambridge, 1892-1925.

President of the Papworth Village Settlement,

1918-1925.

A scholar-physician, an inspiring leader, and
a beloved humanist.

“Therefore to thee it was given
Many to save . . .”

Dr. P. C. Varrier-Jones, the Medical Director of
Papworth, wrote:

In the early days there were enormous difficulties to be
overcome, and whenever I had any of these difficulties which
stumped me, they were immediately solved by his wonderful
knowledge of the world and his great intuition as to the
right methods of approach, and his keen intellectual grasp
of the problem. I do not think we could have made the pro¬
gress we have without his guiding hand and it was because
he instinctively knew what line of action to take that we

232

SIR CLIFFORD ALLBUTT

1918 were so successful in laying the foundation-stones on which
we have built ever since.

He never bothered himself about any detail. Any broad
issue I had to discusss with him was discussed quickly,
frankly, and with sure and certain knowledge as if he had
been familiar with all my little problems and had all the
detail at his finger-tips. Knowing as I did that he had lots
and lots of work to do, it was always a matter of astonish¬
ment to me that without any preliminary manoeuvring he
gave me his undivided attention at once. ... I never wrote
a letter which he did not answer by return of post.

In the March and September numbers of the
Classical Review1 he noticed at some length two trans¬
lations of Theophrastus; the first was Sir Arthur F.
Hort’s Theophrastus' Enquiry into Plants and minor
W orks on Odours and Weather Signs, and the second,
Professor G. M. Stratton’s edition and translation of
Theophrastus and the Greek physiological Psychology
before Aristotle. This reading was utilized in his Greek
Medicine in Rome (1921), as is shown by the text and
references.

Sir George Newman’s Memorandum on Medical
Education in England to the President of the Board
of Education was reviewed at some length and in
highly appreciative terms by Allbutt,2 who began by
saying that “Medicine as a function of civil society
has come late into the field. The Church, on its
secular side, and the Law gained power and influence
while room and gear were yet simple. Late comers at
a feast have a cool reception. ... To attempt even a
survey of this large and rich contribution to the new
birth of medical education is out of the question.”
He welcomed the emphasis laid on the general practi-

1 Classical Rev., London, 1918, xxxii. 30, 117.

* Brit. Med. Joum., 1918, ii. 113-15.

SIR CLIFFORD ALLBUTT

233

tioner as the foundation of medicine in this country,
and parenthetically expressed the wish that there
were a better name for these medical men, such as
the good old one of physician still preserved in the
United States. Stress was then laid on the want of
correlation between different branches, thus “the
pathologist, not by any means of his own fault, is
compelled by his divorce from the clinical wards to
work in a balloon”. Preventive medicine, too, by the
water-tight compartments between different branches
of research, was in danger of becoming sterile.
Bridges should be built between physics, bio-chemis¬
try, and clinical medicine. Clinical medicine was
taught almost wholly as an art rather than a science,
and if clinical medicine is to advance there must be
properly endowed professors with efficient labora¬
tories and assistants devoting the greater part of
their time to teaching and research; he had “often
spoken of Harley Street as the grave of the great
clinical teachers of the London hospitals”.

In March he published notes from a clinical lecture
on a case of Huntington’s chorea,1 mentioning that
this was the fourth example of this rare disease that
he had seen; he shortly afterwards supplemented this
by a brief memorandum on a patient suffering from
“shell-shock”, but superficially resembling Hunting¬
ton’s chorea.2 He also wrote letters on thrombosis
and embolism3 and on pneumonia and toxaemia.4

The late J. G. Adami’s Croonian Lectures on
“Adaptation and Disease”, delivered before the
Royal College of Physicians of London in June 1917,
and published at the time in the medical press, thereby

1 Brit. Med. Journ., 1918, i. 389. 2 Ibid., 1918, i. 413.

3 Ibid., 1918, i. 385. 4 Lancet, 1918, i. 467.

1918

234 SIR CLIFFORD ALLBUTT

1918 giving rise to a rather vigorous correspondence
with Sir E. Ray Lankester, were published, together
with other papers dating back to 1892 on the same
subject, under the title Medical Contributions to the
Study of Evolution (1918). Adami, when working with
the late Professor C. S. Roy in Cambridge, had come
in friendly contact with the then recently appointed
Regius Professor of Physic, and gracefully recalled
his association in the dedication of this volume to
Allbutt as “Physician, Philosopher and Friend who,
as Regius Professor, presided over the Delivery of
the earliest of these Studies — it and its Offspring”.
The earliest paper here mentioned, “On the Varia¬
bility of Bacteria and the Development of Races”,
was the subject of Adami’s thesis for the degree of
M.D. at Cambridge in 1892.

In September, after ten months’ hard work which
had tired him out, Allbutt took a holiday in the Lake
District. He wrote from the Ullswater Hotel, Patter-
dale, to Dr. J. A. Wright on September 17: “We
move homewards to-morrow after three weeks of the
worst weather I ever remember. Rain every day and
all day mostly. Still, even in tears, the country is
fascinating, and three-quarters of a century of climb¬
ing about the fells makes me loyal to them even in
adversity. Meanwhile I have made way in editing my
FitzPatrick lectures.” These lectures at the Royal
College of Physicians of London on “The History of
Medicine”, delivered in 1909-10, and published in the
medical journals at the time, were now much ex¬
panded, and, together with other historical essays,
published in 1921 as Greek Medicine in Rome (Mac¬
millans, pp. 633).

In the autumn of 1918 a clinical lecture given by

SIR CLIFFORD ALLBUTT 235

him at Addenbrooke’s Hospital on “Renal Dropsy”1
appeared; it dealt with the treatment recommended
in 1917 by A. A. Epstein of the Mount Sinai Hospital,
New York, whom he had met some years before, of
chronic parenchymatous nephritis by a diet contain¬
ing large quantities of protein with a minimum of
carbohydrates and exclusion of fats. At this time,
with the late Sir William Osier and Sir George New¬
man, he was preparing the ground for a serious con¬
sideration of the establishment of whole-time pro¬
fessors of medicine and clinical units.

1919

The world was now busy in the process of recon¬
struction after the War, and Cambridge was not
behindhand in this respect. Among other matters
which took time and thought was the initiation of
a Diploma in Medical Radiology and Electrology
(D.M.R.E.) which was established by a Grace of the
Senate on June 17. As in the case of the Diploma in
Public Health, established in 1875, Cambridge led
the way, which has been followed elsewhere; Diplomas
in Public Health are given by a number of bodies,
such as that granted jointly by the Royal Colleges of
Physicians and of Surgeons in London, but the Uni¬
versity of Liverpool and more recently that of Edin¬
burgh are the only other bodies in Great Britain that
thus encourage a high standard in radiology. The
establishment of this Diploma in Cambridge was fol¬
lowed in 1920 by that of a Lectureship in Medical
Radiology and Electrology, held by the late Dr. F.
Shillington Scales until 1927 and then by Dr. A. E.

1 Brit. Med. Journ., 1918, ii. 395.

1918

236

SIR CLIFFORD ALLBUTT

1919 Barclay, previously (1921-28) lecturer in Radiology
in the Victoria University of Manchester.

At the annual meeting of the British Medical As¬
sociation in 1914, at Aberdeen, the choice of the
President-elect for the meeting designed to be held
in Cambridge in 1915 naturally fell on the Regius
Professor. The War prevented any regular annual
meeting until 1920, when the postponed meeting at
Cambridge took place under the presidency of All¬
butt, who thus occupied this office for the unparalleled
period of six years. But on April 10-11, 1919, a suc¬
cessful Clinical and Scientific Meeting, intended to
deal with the lessons taught by the War, instead of
the usual annual meeting in July, was held in London
under his presidency, and he gave an address on
medicine in the twentieth century entitled “The
New Birth of Medicine”,1 thus really completing the
account of medicine from the time of the early
Greeks which he had given in various articles and
addresses during his long life of activity. He dwelt on
the light thrown upon Medicine by physics, and said:
“We cannot even guess at the links of the chains
where physics recede and bio-chemistry takes the
lead”. He mentioned the rich harvest which Medicine
had reaped in the recent war from bio-chemistry, and
after pointing out that the working medical man can¬
not be a bio-chemist, urged that in every good clinical
school there should be whole-time professors with
properly equipped laboratories and staffs, who should
be “continually irrigating the profession from the
sponge of pure science”. After further insisting on
the importance of linking up the laboratory with the
wards he went on: “If I am not a practical man I am

1 Brit. Med. Journ., 1919, i. 433-8.

SIR CLIFFORD ALLBUTT 237

nothing, but still I am convinced that only by dis¬
interested research on the large, patient, and pro¬
phetic lines of the pure sciences can progress be
made. ... So complete and mischievous, however,
has been the barrier between research and the indus¬
try of Medicine that a reaction from ‘laboratorism’
to symptomatology has set in, because there are no
intermediary workers — no engineers — between the
knowledge getters and the knowledge dealers. Thus
we see the laboratory investigators completely out of
touch with practice, and practitioners faithless of
theoretical principles — just ‘Philistines’. A few years
ago my own University, or certain members of it, dis¬
couraged the establishment of a brewing school for
which endowments were offered; utterly ignorant and
careless as they were that Pasteur’s great discoveries
began in the wine vat.”

Writing on endurance in aortic insufficiency1 he
quoted two cases of long duration, one of which he
had watched for twenty-five years, and laid stress on
the bad prognosis when extrasystoles make their ap¬
pearance, such cases being prone to terminate by
sudden death. To the fifth and posthumous edition of
Sir Hermann Weber’s Longevity and the Means for the
Prolongation of Life, he wrote a charming preface,
giving some reminiscences of his friend, who, like
himself, was an alpine climber long after what for
most people would be an unusual age.

When on July 11, 1919, to celebrate the seventieth
anniversary of Sir William Osier’s birth (July 12,
1849), his friends made a presentation of two volumes
of scientific contributions specially written for the
occasion by one hundred and fifty of them, Allbutt,2

1 Brit. Med. Journ., 1919, i. 85. 2 Ibid., 1919, ii. 80.

1919

238 SIR CLIFFORD ALLBUTT

1919 as his brother Regius, was appropriately selected to
express the affection of the great body of subscribers
on both sides of the Atlantic.

My dear Colleague — To me, as one of your oldest
friends in time, and perhaps the oldest in age, has fallen the
honour of announcing our celebration of your seventieth
birthday — one anniversary of many years of supreme ser¬
vice in two kindred nations and for the world. The last
lustrum of your threescore and ten, if now merged in victory,
has been a time of war and desolation, of broken peoples,
and stricken homes; yet through this clamour and destruc¬
tion your voice, among the voices in the serener air of faith
and truth, has not failed, nor your labour for the sufferings
of others grown weary.

But, while thus we celebrate your leadership in the
relief of sickness and adversity, we are far from forgetting
the sunnier theme — the debt, none the less, which we owe to
you in other fields of thought. In you we see the fruitfulness
of the marriage of science and letters, and the long inherit¬
ance of a culture which, amid the manifold forms of life, and
through many a winter and summer, has survived to inspire
and adorn a civilization which so lately has narrowly
escaped the fury of the barbarian.

And now I will not avoid a topical allusion — an allusion
to your recent presidential address to the Classical Associa¬
tion at Oxford; an address which, in its various learning, its
wisdom, and its wit, brilliantly illustrated this fecundity of
letters and science, embodied the common spirit of science
and art, conferred a distinction upon our profession.

In these volumes we hope you will find the kind of
offering from your fellow workers which will please you
best — immaterial offerings indeed, but such as may outlive
a more material gift. As to you we owe much of the inspira¬
tion of these essays, and as in many of their subjects you
have taken a bountiful part, so by them we desire to give
some form of our common interests and affections.

We pray that health and strength may long be spared

SIR CLIFFORD ALLBUTT

239

to you and to her who is the partner of your life; and that 1919
for many years to come you will abide in your place as a
Nestor of modern Oxford, as a leader in the van of Medicine,
and as an example to us all.

In the course of his reply Osier said, “To you, Sir
Clifford, in fuller measure than to any one in our
generation, has been given a rare privilege: to you,
when young, the old listened as eagerly as do now,
when old, the young. Like Hai ben Yagzan of Avi¬
cenna’s allegory, you have wrought deliverance to all
with whom you have come in contact.” The auto¬
graph manuscripts of these two speeches are in the
Osier Library at McGill University ( Bibliotheca
Osleriana, No. 7659).

The two volumes, which were not actually finished
and published until the end of December, contained
a scholarly article by Allbutt on “The Innate Heat”,
and were prefaced by his charming proem:

My dear Colleague — The stealthy foot of Time carries
us from youth to age so imperceptibly that we are hardly
aware of the change; insensibly we shorten our arms, hus¬
band our strength, and are willing to think our prowess
undiminished. Yet men have not refrained from marking
the lapse of time by signal days, and months, and years;
often by celebration of those whose lives have been devoted
to the good of their kind, often by memorials of joy and
achievement, or again of bitter and unforgotten sorrow.

And, as for the nation or the race, so in his own life, are
there for each of us memorable days of sympathy in joy and
sorrow. One day of sympathy in joy was that in the summer
of 1904, when some of us were gathered around the hospitable
hearth of Sir John and Lady Burdon-Sanderson, and, as
suddenly, I believe, to you as to others of us, like a flash
of light the thought was born, how, one scarcely knew, that
you might surrender your great functions at Baltimore to
enter upon a new life at Oxford.

210

Sill CLIFFORD ALLBUTT

1919 Ever in the heart, of the folk of the New World lies warm
and deep kinship with the old home; thus, almost with the
rapidity of thought, between Canada, the United States,
and Great Britain an academic link threefold was forged.
In no person as well as in your own could this unity have
been so happily consummated; you arrived indeed from
overseas but as a pilgrim child of Oxford. In you the literary
and historical tradition of the beautiful city was united with
the zeal and adventure of the New World; so that in winning
you for Oxford, and for Cambridge and Great Britain, we
did no robbery to Baltimore and Montreal.

Since that day we have shared, in our degrees, your
happiness and your sadness; we have rejoiced in your
honours, and on this day, when you reach the limit that
the men of old regarded as the last ripeness of a man’s life,
I, your brother Regius Professor, am permitted to offer to
you from both worlds, as a tribute of admiration and
affection, our little horn, if not of plenty, yet of the best of
our gardens.

Your “radical humours contain more than sufficient Oyl
for seventy years”; oyl enough to keep your lamp trimmed
and bright till the old world, now tardily procreant, be
brought again to the birth. Meanwhile, in good days or evil,
you can thankfully say after our great Example— “My
Father works hitherto and I work”.— Affectionately yours,

Clifford Allbutt.

Cambiiidge, July, 1919.

To the Memorial Number of Appreciations and
Reminiscences of Sir William Osier of the Inter¬
national Association of Medical Museums (Bulletin
No. ix.), edited by Maude E. Abbott, published in
1926, he wrote another charming proem, the final
revision of the page proof of which arrived only a
few days before his own death. It began:

I was under the belief that I knew William Osier well,
intimately, almost as a brother; now I am learning how

SIR CLIFFORD ALLBUTT

241

much I was mistaken. I did not know the half of him. I
wonder if he himself realized all of that many-chambered
mind of his, all of those many accomplishments! We others,
who knew a little of his scientific researches, of his riches of
knowledge, of his jewels of art and letters, we, in too many
of these pursuits, were little more than children fascinated
by precious stones; soon tired or tempted away we poured
them back into the bowl, and forgot them. Osier diligently
fashioned them all one by one into his patterns, adding
group to group until none of us knew the full extent of his
possessions.

A little further on he wrote;

A perusal of some advanced sheets of Professor Cushing’s
biography sets Osier before us in a bright light, not only as
a practised and ardent worker in this field [of zoology], but
also as a pioneer; and yet one so modest that, although my¬
self an old friend of George Busk, G. H. Lewes, and other
former leaders in the study of polyzoa in England, I had no
notion of Osier’s standing and researches in this branch of
science. . . . Osier did not accumulate books as a hobby only;
he knew them inside and out, and, moreover intended them
for that great service whither now they are being consigned.
One day when I said to him, “You seek for the first edition
of a book, I seek for the last”, he truly replied, “I want
both”.

He also wrote the dedication, in the form of a
letter, to the volume of Essays on the History of
Medicine presented to Karl Sudhojf on the Occasion of
his Seventieth Birthday, November 26, 1923, edited by
Charles Singer and Henry E. Sigerist. In it he said:

Many years have elapsed since we met at the table of our
lamented friend, William Osier, in whom the world has lost
one of its most brilliant teachers of Medical History. At that
time I remember you had already established at Leipzig
the Institute of Medical History which, as a monument of
your eminent career, and of our debt to you, will stand only

R

1919

242

SIR CLIFFORD ALLBUTT

1919 lower than the monument of your many achievements. . . .
Your knowledge of your subject and your original researches,
beyond those of any other living man, are so vast that it is
hard to say what parts of an infinite subject have not been
enriched by your pen.

In August and September the Allbutts were in
Yorkshire, at Harrogate first and then at Scar¬
borough. On August 10 he wrote to Sir George New¬
man on the subject of whole-time professors in medi¬
cal units, a project which had been making consider¬
able way, saying that “if the hospitals expect to find
full-grown candidates for professorships they will not
get them, or but one here and there of self-seeded
saplings. To have candidates as required means a
nursery (and I may add skilled cultivators). Nearly
all men of any maturity have committed themselves
to private adventure and, even if disposed to change
their whole plan of life, are probably spoiled for
academic work. I see no way but to back some young
man — keen and of intellectual promise, and trust to
luck — say a man of twenty-eight or thirty. It is a
chancy way, but so far as I see, the only way. Then
as staffs become established and flourish they will
breed and grow their own successors.”

On Thursday, October 16, he preached before an
audience containing many medical men a sermon for
St. Luke’s day in Leeds Parish Church from the text,
“Were those upon whom the tower in Siloam fell,
sinners above all men that dwelt in Jerusalem?” (St.
Luke xiii. 2, 3, and 4), and insisted on the importance
of preventive medicine, pointing out that epidemics
of disease are not manifestations of an offended deity
but the consequence of the nation’s want of wisdom.
At the Commemoration of Benefactors on the last

SIR CLIFFORD ALLBUTT

243

Sunday in October, he preached the customary sermon 1919
in the chapel of Gonville and Caius College.

In November he was elected an Honorary Fellow
of the Royal Society of Medicine in company with
the late Sir William Osier, three Presidents of the
Royal Society — Sir J. J. Thomson and his successors,

Sir Charles Sherrington and Sir Ernest Rutherford—
the late Sir Patrick Manson, the late Sir William
Macewen, the late S. G. Shattock, Sir A. E. Wright,
Professor Karl Pearson, Emile Roux of the Pasteur
Institute, W. W. Keen of Philadelphia, and George
Crile of Cleveland, Ohio.

“The Times” of December 8 contained a letter
from him, headed “Medical Research: the Claims of
Comparative Pathology”, in which he said: “To
establish in Cambridge a central Institute of Com¬
parative Pathology, which must include professorial
units for the diseases of plants and animals and the
means of blending these departments with the neigh¬
bouring departments of the diseases of man, will no
doubt cost much money, but a sum which, when
compared only with the waste and destruction of
stock and crops, which I have deplored, would prove
to be small indeed. Such is the utilitarian promise;
but far beyond this we cannot tell how bright will
be the cross lights which in a system of comparative
medicine will be thrown reciprocally upon the fields
of the several pathologies of all kinds of life.”

Under the heading of “Medicine and the People:

A Review of some Latter-day Tracts”,1 thus remind¬
ing the reader of Thomas Carlyle, he wrote an essay
on Sir George Newman’s two publications — Some
Notes on Medical Education in England (1918) and

1 Brit. Med. Journ., 1919, ii. 703.

244

SIR CLIFFORD ALLBUTT

1919 An Outline of Preventive Medicine (1919). He drew
attention to the width of the problem of disease,
and defining disease as a failure in the equilibrium
that constitutes health, or some disorder in the inter¬
play, picturesquely continued: “Some actor in the
drama, on the one side or the other, has missed his
cue, or struck the wrong note; or some foreign actor
has thrust himself upon the stage. The result is that
the interplay, the dynamic balance, attained in the
continuity of readjustments over many ages, is dis¬
ordered or upset.” Sir James Mackenzie’s attractive
plea for the investigation of the beginnings and early
stages of disease was thoughtfully criticized; that this
method must be ultimately adopted was admitted,
but probably not in the early periods of research and
not until pathology was more advanced; he thought
that the origins of disease would be more rapidly
revealed by working back from its fully developed
stage; a difficulty in studying the incipient manifesta¬
tions of disease was that the “margin of safety” or
reserve power of the body may compensate for dis¬
ease until much structural damage has been done.
As in his address on “The New Birth of Medicine”,
inspired, as he here hinted, by his return during the
War to full responsibility for hospital patients after
twenty or more years of lecturing on medicine, he
advocated the “University quality” of teaching
which “should lift medicine — preventive and clinical
alike — out of the ruts of mere cleverness, adroitness
in detail, handbook learning, empirical rules, into a
larger and steadier atmosphere”. The dearth of
“middlemen who shall join the discoveries of the
scientist to the practice of medicine” was lamentable,
and he protested against the tendency to deprive the

SIR CLIFFORD ALLBUTT

245

general practitioner of his invaluable work for the 1919
health of the community.

1920

In January he contributed to Nature a charming
obituary1 of Sir William Osier, who died on Decem¬
ber 29, 1919, saying: “A quality which made Osier
so fascinating a companion, his teaching so vivid
and telling, and his parts in debate often so lively,
was his wit and humour, the sharpness of the wit
tempered by the sweetness of the humour. Indeed,
much of his playfulness and whimsical mystification
were, in naturalist’s phrase, a protective colouring
to cover deep sensibilities.” On January 8 he wrote
to Sir George Newman:

Your letters are so welcome and often so comforting as
is this concerning dear Osier. I have felt his death grievously.
Almost ready for press I have a largish book on Graeco-
Roman and Byzantine medical history, and he is gone to
whom my first copy would have been sent. I was unable to
see the dear man near the last; he became so much worse
that all access to him was denied. At Christ Church Lady
Osier asked me to join the family of mourners, and two
hours later I sat for an hour with her. She is (as yet!)
brave and collected. But as yet there is much to do, and I
hope there will be — then the blank will come — the sinking
heart, so forlorn, alone, child and husband gone! With the
loss of our nursery ideas of heaven it seems harder to trust
in the unseen; but the voice of God speaking within us
should give us all faith and hope. Osier is, as soon some
more of us will be, with Him, and this should be enough.

In this year The Oxford Medicine in six volumes,
edited by Henry Christian, Hcrsey Professor of the

1 Nature, London, 1919-20, civ. 473; also reproduced in part in
Brit. Med. .Journ., 1920, i. 04.

246 SIR CLIFFORD ALLBUTT

1920 Theory and Practice of Medicine, Harvard Uni¬
versity, and Physician-in-cliief to the Peter Bent
Brigham Hospital, Boston, Mass., and Sir James
Mackenzie, Director of the St. Andrews Clinical
Institute, began to come out, being published by
the American Branch of the Oxford University
Press. Like another American post-war work on
medicine, Nelson’s Loose-leaf Medicine, a Perpetual
System of Living Medicine , in seven volumes, for
which Allbutt wrote a short introduction, Oxford
Medicine was so bound as to be capable of being
kept up to date without a complete reprinting of
each volume. To the second volume (1920) of Oxford
Medicine Allbutt contributed the article on diseases
of the pericardium and mentioned that “as an ardent
pupil of Trousseau, whose operative treatment for
empyema he had been already carrying out at the
Leeds Infirmary”, he had the pericardium tapped in
1866. In the fourth volume (1921) the article on gout
was written by Allbutt with the collaboration of
Professor (later Sir) F. Gowland Hopkins and Dr.
C. G. L. Wolf, who provided the section on purine
metabolism in relation to gout. In this article he
made good use of his practical experience when a con¬
sultant at Leeds in the seventies of the last century;
thus, “with a middle-aged colleague, I saw in con¬
sultation a patient, aged only about thirty-five . . .
among other questions I asked him it he took snuff.
On retirement for consultation my colleague asked
me why I had asked that question. I answered,
‘because snuff is often infected by the lead papei in
which it is wrapped up’. He mused upon this and
said, ‘Then that is where I get my gout’; and so it
was — his snuff proved to be thus contaminated with

SIR CLIFFORD ALLBUTT

247

lead”. With regard to local treatment he recom- 1920
mended for the larger joints wrappings of carded
wool, adding, “The best of these we had in the West
Riding as ‘tops’; these are streams of greasy wool
as they come exquisitely soft out of the carding
machines”. While admitting the absence of any
evidence about the effect on the blood and urine of
the “Salisbury” diet, popularly supposed to suit
the gouty, he went on, “A distinguished friend of
mine, who supposed himself to be gouty, lived on
this diet for all the later years of his long life; in his
opinion with great advantage, and the patient ought
to know”. In referring to the hepatic factor he re¬
marked: “The patient who, to the veiled scepticism
of his doctor, complains of his liver, may be more
often right than we are apt to suppose”. A verbal
aphorism of his may be quoted in this connection,

“A gouty man is not a bird”.

He gave evidence before the Earl of Athlone’s
Post-Graduate Medical Committee which brought
out its report in May 1921, and deprecated the pro¬
posal to set aside a single hospital for post-graduate
instruction. On March 5 he wrote to Sir George
Newman:“Friends can often dispense with speech;
it was nice to see and feel that you were there. Of
course you had your ritual, but ritual I sometimes
find is calming to the tired spirit; and I am always
a little tired in spring. The cordage of the human
package seems then to get slack! When I have
finished my classes this morning I leave for Lady
Osier’s for the night.”

On March 22, he and Sir James Mackenzie pub¬
lished an appeal1 asking medical men to send any

1 Brit. Med. Journ., 1920, i. 484.

248

SIR CLIFFORD ALLBUTT

1920 spare papers and journals on science or medicine
to Vienna, where, as they heard from Professor
K. F. Wenckebach, there was a veritable famine in
intellectual as well as ordinary food. On March 29
he wrote to Professor W. S. Thayer, of the Johns
Hopkins Hospital, Baltimore, in reply to a request
for permission to reprint Professor W. H. Welch’s
article on thrombosis from the first edition of the
System of Medicine in a volume of his publications
to celebrate his seventieth birthday: “I think that
the decision does not rest with me, so I have for¬
warded your letter to Messrs. Macmillan & Co.
There can, I presume, be no objection whatever to
the reprinting of Welch’s article — rather the con¬
trary, as it reflects honour on us. We desire, my
wife and I, to send our affectionate greetings to
that ‘dear but wicked man’ as we used to call him.
I fear that we can hardly hope to see either him or
you at our British Medical Association Meeting in
Cambridge this summer, June 28 and following
days. I was at Lady Osier’s about ten days ago; she
is well in health, but looks worn and aged, poor
thing; she intends (as yet) to stop in Oxford. But
what a solitude after such a happy home! Tell Welch
with my love that I hope he will be as well and happy
at seventy as I am at fourteen years older!”

In the spring, at the annual meeting of the As¬
sociation of American Physicians, he was elected the
first honorary member living out of America; at the
same time Professors P. Heger of Brussels, Roux of
the Pasteur Institute of Paris, and Marchiafava of
Rome were elected. This Association, which consists
of two hundred active members, was founded in 1886,
and is on much the same lines as the Association

SIR CLIFFORD ALLBUTT

249

of Physicians of Great Britain and Ireland, founded
in 1907, largely as the result of the inspiring enthusi¬
asm of the late Sir William Osier, who was also one
of the founders, and in 1895 President, of the
American Association.

The following letter was in response to a request
from Professor Harvey Cushing of Boston, Mass.,
who was collecting material for his splendid Life of
Sir William Osier:

Cambridge, England,
April 1, 1920.

Dear Harvey Cushing — If anybody can catch the
varying forms and lights of Osier’s character, and relate
the phases of his life, it is yourself.

Alas! as to letters your path will be a thorny one: he
rarely wrote a “letter” so far as my experiences count; he
dealt in flying post cards — two lines of business and half a
line of jest or witty comment on current affairs. These un¬
luckily, after their kind, would get lost; Keith begged of me
what I had for the Royal College of Surgeons of England.
I found one longer letter, and sent it to him — perhaps after
the “little clinical note from his sick bed” (I had not a few
of these post cards in the early stages, but never dreaming
of the event, failed to keep them). If Arthur Keith has not
lent you the letter I gave him he will do so no doubt. I
cannot think of anyone who would have letters. I should
guess he wrote few letters of any length. I fear we cannot
hope to see you here during our British Medical Meeting at
Cambridge (June 27-July 3). How gladly we would entertain
you; I have not been lucky in meeting you when you have
been in England. Excuse haste for return mail. — Always
very sincerely yours,

Clifford Allbutt.

On May 9 he preached, in the chapel of Gonville
and Caius College, a sermon which left a lasting im¬
pression on his audience.

1920

250

SIR CLIFFORD ALLBUTT

1920 The first regular annual meeting of the British
Medical Association after the War was held on June
30, July 1 and 2, at Cambridge; there had not been
a meeting there since 1880, when Sir George Murray
Humphry in his presidential address traced through
the past centuries the long neglect of medicine at
Cambridge, and insisted on the broad scientific edu¬
cation that should be given there in addition to the
strictly professional instruction. In his presidential
address, delivered in the Senate House on the evening
of June 29, on “The Universities in Medical Research
and Practice”,1 Allbutt gave a characteristically wide
review of this subject, touching on general practice,
preventive medicine, and commenting with force and
pungency on the modern psycho-analytical develop¬
ments of psycho-therapy. In speaking on compara¬
tive pathology he recalled Sir James Paget’s address
on plant pathology in 1880 at the previous meeting
at Cambridge, and quoted Sir Henry Acland’s dictum
in his presidential address to the Section of Public
Health, that the pathology of man and domestic
animals could not be separated, and that he had there¬
fore advocated a chair of general and comparative
pathology at Oxford. Allbutt also referred to his own
address in Medicine at the Glasgow meeting in 1888,
in which he appealed for study in this direction, but
“found no response, hardly an echo”. After the
address in the Senate House the audience flocked to
the adjacent hall of King’s College, where Sir Norman
Moore, President of the Royal College of Physicians,
who, together with Allbutt and Sir George Makins,
President of the Royal College of Surgeons, had that
day received the honorary degree of LL.D., presented
1 Bril. Med. Journ., 1920, ii. 1-8.

SIR CLIFFORD ALLBUTT

251

to Allbutt his portrait by Sir William Orpen, R.A., 1920
for which the profession had so widely subscribed.

In doing so Moore compared Allbutt with his most
distinguished predecessors in the chair, especially the
scholarly Ralph Winterton (1600-35) of King’s, who
turned the aphorisms of Hippocrates into Greek
verse and was Regius Professor for one year only,
and with Francis Glisson (1597-1677) of Caius, who
described rickets, the structure of the liver, and
irritability, and was Regius Professor of Physic for
one-and-forty years, and, like John Caius, President
of the Royal College of Physicians of London (1667-
1670). The portrait, exhibited in the Royal Academy,
now has a permanent home in the Fitzwilliam
Museum at Cambridge, and a pleasing mezzotint
engraving was made by H. R. Macbeth-Raeburn,
A.R.A. A plaque, done after his death by Mrs. Mary
Gillick, was presented by Lady Allbutt to the Allbutt
Library, which now occupies what was the Kanthack
Library (now moved to the Pathological Depart¬
ment) in the Medical School. This was unveiled on
May 18, 1929, when Sir James Crichton-Browne de¬
livered an affectionate eloge. On July 5, to the uni¬
versal approval, his appointment as a Member of
His Majesty’s Most Honourable Privy Council was
announced. With the exception of T. H. Huxley in
1892, no medical man in recent years had received
this high honour, save for political services, and there
is reason to believe that it was more welcome than
the peerage, which many of his friends anticipated.

On August 9 he wrote a letter about pleural reflex
syncope,1 drawing attention to the demonstration by
Sir H. K. Anderson, Master of Caius College, that

1 Brit. Med. Journ., 1920, ii. 255.

252

SIR CLIFFORD ALLBUTT

1920 experimentally stimulation of the vagus “may bring
the heart to mortal arrest, if the organ be in some
way and degree enfeebled”. He contributed one of
the Memorial Tributes1 to Sir Norman Lockyer
(1836-1920), who died during this month and was
his exact contemporary.

In September he and his wife were in Guernsey
and visited the County Hospital, where he left behind
a graceful and appreciative note about its efficiency
in the visitors’ book. In an article on “Modern Thera¬
peutics”,2 published this month, he said that, just as
Lister by means of bacteriology had brought about
a new birth of surgery, so was medicine being re¬
generated by physics and chemistry.

On Sunday, November 7, he preached the evening
sermon in Dewsbury Parish Church from the text,
“They said unto him, ‘Master, where dwellest thou?’
and he saith unto them, ‘Come and see’ ” (St. John i.
38-39). He began: “We are here to-night to celebrate
the festival of All Saints — All Hallows — and it is well
therefore that we should take this opportunity of
thinking what we mean by saints, why they were,
why they are, where they are to be found, and what
it is that makes a saint.” Later on he pointed out
that sainthood depends upon the inward life, but is
not merely an unpractical dreamy life, that the most
powerful people in the world are practical idealists,
and that great saints, such as Theresa, Bernard,
Catherine of Sienna, and, in more modern times, Mrs.
Elizabeth Fry, were most practical people.

Under the heading “Modern Universities”, in
“The Times” of November 20, a letter of his appeared

1 Nature , London, 1920-21, cvi. 25.

2 Practitioner, London, 1920, cv. 157-63.

SIR CLIFFORD ALLBUTT 253

defending the older universities, and pleading on their 1920
behalf for financial help.

In the course of a letter to Sir George Newman,
dated December 28, he wrote: “You know that a
Diploma of Radiology has been established — head¬
quarters here, much of the clinical teaching in Lon¬
don — which is going famously ahead. One thing we
have had impressed upon us — namely, that in the
hands of self-taught (and otherwise) amateurs, how¬
ever much they may fancy themselves — radiology
is first of all a very dangerous weapon; secondly —
in diagnosis — very misleading. . . . We have two
parts in the curriculum, the first scientific — largely
under the aegis of Rutherford — and the second
technical, under the London bigwigs and in a measure
here also.”

1921

In a letter dated February 2 to Professor F. Hob¬
day, who on the following day gave an “occasional”
lecture at the Royal Society of Medicine, entitled
“Observations on some of the Diseases of Animals
Communicable to Man”, he regretted his inability to
come to discuss a subject on which, since 1888, he
had been speaking and writing with the object of
bringing about the consolidation of students in all
branches of Medicine. As the outcome of this lecture
there was a combined meeting on March 14 of the
Royal Society of Medicine and of the Central Branch
of the National Veterinary Medical Association, with
Sir John Bland-Sutton in the chair, to discuss “the
eradication of tuberculosis in man and animals”.
After Sir John McFadyean’s opening address on
bovine tuberculosis and Professor Lyle Cummins’

254

SIR CLIFFORD ALLBUTT

1921 remarks on infected milk, Allbutt1 put forward a
plea for comparative pathology saying that, so far
as he knew, pathology was the only subject which
had hitherto declined to call — or at any rate had
been supine in calling — the comparative method to
its aid. He described the chairman, Sir John Bland-
Sutton, as one of the strongest links between human
and comparative pathology. In a letter to the medical
press2 on referred pain he drew attention to the ex¬
perimental work of the late Sir H. K. Anderson,
Master of Gonville and Caius College, and contested
Dr. A. F. Hurst’s view that the viscera are sensitive.

In 1914 he had, with Sir William Osier, been one
of the first in England to advocate, in a Memorial to
the University of London, systematic university in¬
struction in medical hydrology; it was therefore
natural when, seven years later, another movement
was made to strengthen the scientific basis of practice
by gathering all the workers in hydrology into a com¬
mon union, that Allbutt should be the first Honorary
Member of the International Society of Hydrology,
and should contribute a historical preface to the first
number of its journal, the Archives of Medical Hydro¬
logy, which came out in May 1922.

In a letter3 on May 14 he contested the statement
that the Adams-Stokes syndrome signified degenera¬
tion of the heart muscle, and quoted a case under his
observation in which the pulse rate had been as low
as six per minute; the necropsy showed that there
was aortic stenosis, and that fibrous condensation,
beginning no doubt at the aortic collar, had gradu-

1 Proc. Hoy. Soc. Med., 1920—21, xiv. 15.

2 Lancet, 1921, i. 450.

a Brit. Med. Journ., 1921, i. 755.

SIR CLIFFORD ALLBUTT

255

ally invaded the a-v structures; but microscopically 1921
the greatly hypertrophied heart presented little or no
default, except a slight degree of fibrosis. A few
weeks later an annotation in the same journal1 on the
pronunciation of the word vitamin quoted the opinion
obtained from him that in the first syllable i is long.

On May 31 he wrote to the Chemical Age strongly
supporting Sir W. J. Pope’s contention in his article
“The Case for Chemical Warfare”2 that, as under
modern conditions war has become a mere orgy of in¬
genious brutality and rapine, and has ceased to en¬
gender even incidental virtues, poison gas cannot
make it any worse. He also pointed out that Professor
Pope’s defence presented “a feature which by its
very nature lies below the surface; the discourse is a
masterpiece of irony, a piece not unworthy to stand
beside the work of the great master of that mode.

The irony is so profound, so masked, that some of
your readers may have paid for carelessness of read¬
ing by missing the inward meaning. Swift himself
never penned a more masterly paragraph than that
in which Sir William gravely proves that in the last
war preventive medicine was responsible for the
slaughter of nine-tenths of 15,000,000 men; to which
must be added our ‘distribution of epidemic disease
among non-combatants in all quarters of the globe’;
and again, ‘the civilian mortality from the mysteri¬
ous war form of influenza alone amounted to scores
of millions; and the death roll lies at the door of pre¬
ventive medicine’. Hygienists may be as much con¬
founded with astonishment as were Blefuscudians.”3

Under the heading of “Design in the Arts:

1 Brit. Med. .Town. 1921, i. 820.

2 Chemical Age, 1921, iv. 520-8. 3 Ibid.. 1921, iv. 018.

256

SIR CLIFFORD ALLBUTT

1921 Unnamed Craftsmen” a letter from him appeared in
“The Times” of June 1, drawing attention to the
absence of public recognition of the artists’ names in
connection with their products, and pointing out
that artists were exploited by commercial firms —
upholsterers, silversmiths, glass-painters, and organ
builders — who took the credit. What kind of portrait,
he asked, should we get if they were ordered through
a picture dealer and not from the artist? “Yet in this
way we order a painted window, an organ, or a
chalice; and get what we deserve.”

On June 3 he wrote to Lieut. -Colonel F. H. Garri¬
son, of the Library of the Surgeon-General of the
United States Army, Washington, D.C.:

I have asked Messrs. Macmillan to send you a copy of
my volume (just out) of several treatises (including the
Byzantine Medicine which you were so good as to approve),
especially my FitzPatrick Lectures on Greek and Roman
Medicine. I submit it you with some trepidation; I know
well how humble an effort it is beside your History, and your
many other most interesting tracts; but I hope — compara¬
tively slight and second-hand as it is — that it may have a
not unfavourable reception in the United States.

In reviewing Dr. S. Holth’s book on Greco-Roman
and Arabic Bronze Instruments and their Medico-
Surgical Use, Allbutt1 pointed out that Hippocrates,
though generally regarded as “an insurgent genius
springing as it were full grown out of the brain of a
rudimentary age”, must have been preceded by a
school of much experience of which no trace has been
left.

On June 24 he wrote to Professor Pope thanking
him for a reprint of his address “The Case for

1 Classical Rev., London, 1921, xxxv. 10G-7.

SIR CLIFFORD ALLBUTT

257

Chemical Warfare”, and then passed on to quite 1921
a different subject, namely, the superannuation of
professors on attaining the age of sixty-five years,
which had recently been debated in the Senate House
at Cambridge as a result of the recommendations
of the Royal Commission, and was afterwards carried
into effect. Allbutt wrote: “I was much in accord with
your views expressed in the Superannuation Debate.

It is not for an old man to argue about it; but I am
sure the Commission is making a mistake. They
have taken examples from the Civil Service, and
there (I remember well) the scheme was primarily
to accelerate and define 'promotion. Here the pro¬
fessorships rarely go by promotion, and it would be
a pity if this became the custom — groovy and often
second best. But in respect of calls from without, a
man hardly becomes distinguished much before
middle life — say towards aet. 50 or so. Well, for a
man to pull himself up by the roots — to take up
new ways and new colleagues, etc., and moreover
to uproot his wife and household and remove to
another place — migration, refurnishing, redecora¬
tions, etc. — all cost money; and with only fifteen
years certain to look forward to — is it worth his
while? And the people where he is will have more
opportunity to make it better worth his while to
stop with them. And is it not a sad thing to see first-
class men stranded in fulness of life — Ray Lankester,
Thorpe, Prain, Thistleton Dyer; to see their best ten
years sacrificed by loss of all conditions of service,
and of intellectual stimulus, and have to take to
journalism or sitting on a rural Bench of Justices.”

On July 16, in a letter1 bearing on the surgical

1 Brit. Med. Journ., 1921, ii. 129.

S

258

SIR CLIFFORD ALLBUTT

1921 treatment of angina pectoris, which was then attract¬
ing attention, he mentioned that Professor K. F.
Wenckebach of Vienna, on the basis of five hundred
necropsies on cases of angina pectoris, entirely
agreed with his view that the responsible morbid
change was at the base of the aorta; he also remarked
that a few years ago “a dear friend of mine argued
with me that it was ‘a childish opinion’, and advised
me for my own reputation’s sake to say no more
about it”. He was at Newcastle-on-Tyne for the
Annual Meeting of the British Medical Association,
and on July 20 opened a discussion in the Section
of Medicine on visceral syphilis, especially of the
central nervous and cardio-vascular systems; his
address1 was illustrated by an array of specimens
provided by Sir German Sims Woodhead. In the
course of it he said that his original description of
syphilitic periarteritis in 1868 was from a specimen
sent to him from the West Riding Asylum by Sir
James Crichton-Browne, and that Heubner, who,
when he described the condition as primarily an
endarteritis in 1873, had not seen his paper, sub¬
sequently referred to it courteously and accepted
the periarteritis origin. About this time he reviewed2
at some length O. Josue and M. Parturier’s book,
Les cardio-renaux, and the late Professor E. G.
Browne’s Arabian Medicine, which was the text of
the FitzPatrick Lectures for 1919 and 1920 at the
lloyal College of Physicians of London. With feel¬
ings of loyalty for a former colleague, he and the late
Mr. H. Littlewood of Leeds wrote on October 5 a
long letter3 in which, while expressing much appreci-

1 Bril. Med. Journ., 1921, ii. 177-83.

2 Ibid., 1921, ii. 211; 564. 3 Ibid., 1921, ii. 614-15.

SIR CLIFFORD ALLBUTT

259

ation of the late Sir Peter Freyer (1851-1921), whose 1921
obituary had recently appeared, they pointed out
that the priority for the operation of prostatectomy
belonged to the late A. F. McGill, Professor of Sur¬
gery at Leeds. An interesting account of McGill’s
first operation in 1887 was later given by Lord
Moynihan.1 The Moxon Gold Medal at the Royal
College of Physicians of London, awarded every
third year to the person deemed to have most dis¬
tinguished himself by observation and research, was
presented to him on October 18, St. Luke’s day,
after the delivery of Dr. H. R. Spencer’s Harveian
Oration by the President, Sir Norman Moore. At
the Harveian dinner in the evening he responded
for the medallists.

In 1920 and 1921 the thorny question of the
relation of women students to the University, in¬
cluding that of degrees, which had been considered
at great length in 1896 and 1897, was again much
discussed at Cambridge; in April 1921 Allbutt signed
a memorial in favour of a compromise between the
divergent views. On October 20, 1921, two Graces
were voted upon in the Senate House; the first, in
the nature of a compromise and proposing to admit
women to a limited membership of the University,
was defeated by 908 to 694 votes. The second Grace,
proposing to confer the titles of degrees by diplomas
on duly qualified women, but excluding them from
membership of the University, was carried by 1012
to 370 votes. It may be noted that at Oxford, Con¬
vocation on May 11, 1920, approved a Statute making
women students members of the University.

In November Allbutt published “Some Remarks

1 Brit. Med. Journ., 1925, ii. 39.

260 SIR CLIFFORD ALLBUTT

1921 on Clinical Units”1 in the course of which he dis¬
cussed their constitution, saying that it was not
essential that the Directors should entirely eschew
outside practice. He was strongly of opinion that
the Directors of the Units in London should be
elected by a committee of the University of London,
and not by a combined committee on which the
hospitals concerned were largely represented. With
a keen sense of the desirability of maintaining a
high university standard he wrote: “It may be that
professional preparation will divide into two courses
— into a five-years course on craft lines for the
diploma of the Colleges, and a university course for
those who have the turn and the time for wider and
deeper study; a difference which is perhaps coming
about more or less undesignedly. In any ease the
universities must not trifle with their standards.”
In a later letter he said that the Director should be a
comparatively young man, an opinion he had pre¬
viously expressed in writing to Sir George Newman
in 1919 ( vide p. 242). His definition of a clinical unit
was “A body of individuals in union in the search for
and discovery of knowledge”.

1922

On the death on December 29, 1921, at Aisthorpe
Hall, Lincolnshire, of German Sims Woodhead,
Professor of Pathology in the University since 1899,
Allbutt wrote sympathetic appreciations 2 of his
colleague’s sterling qualities of heart and brain. The
notice in The Cambridge Review began:

1 Lancet , 1921, ii. 937; 1299.

Cambridge Rev ., 1922, xliii. 174; Brit . JMed, Journ 1922, i. 40.

2

261

SIR CLIFFORD ALLBUTT

There was wonder, and perhaps some dismay, in the 1922
University when, in the year 1899, descended into one of its
principal chairs a fair-haired blue-eyed man from the North,
a champion sprinter and footballer, and one supposed to
hold those subversive opinions which were known to thrive
among the hardy folk of Yorkshire and Lancashire. And
rumour was not idle. The new professor was reported to be
a sturdy nonconformist, a militant teetotaller, and a stiff¬
necked radical; moreover to belong to a sect, at that time
in ill repute in society, called Resisters — or non-Resisters
was it? — it matters not, the heresy is long dead. And not all
this only; furthermore the new colleague was said also to
speak his mind with the ingenuous and unflinching candour
characteristic of his race. So the Professor’s further acquaint¬
ance was awaited with the good manners of Cambridge yet
with some wariness and a little distrust. . . . The freedom
he claimed for himself he gave ungrudgingly to others. In
him Cambridge learned the truth of the words of Coleridge:

“that religion, in its essence, is the most gentlemanly thing
in the world”.

They were, of course, closely associated in many ways,
and perhaps especially in the practical question of
the Papworth Tuberculosis Colony near Cambridge.
Together with Dr. P. C. Varner- Jones they were
concerned in two books, entitled Industrial Colonies
and Village Settlements for the Consumptives (by Sir
G. S. Woodhead and P. C. Varrier- Jones, with a
preface by Sir Clifford Allbutt, pp. xii and 152,1920)
and Papworth : Administrative and Economic Pro¬
blems (by the late Sir G. S. Woodhead, Sir Clifford
Allbutt, and P. C. Varrier- Jones, with an intro¬
ductory chapter by Sir James Kingston Fowler,
pp. 63, 1925). The latter book brought a grave in¬
dictment against the efficiency of the existing system
of dispensaries and sanatoriums for tuberculosis.

In a dispensary the patients were of necessity seen

262

SIR CLIFFORD ALLBUTT

1922 and treated as out-patients, and it was described
as “an out-patient department stocked with drugs
which are mostly placebos and an annex of an office
for the compilation of statistics”. Sanatoriums were
intended for early cases, but as a matter of fact 90
per cent, or more of the inmates have passed this
stage, for in Kingston Fowler’s epigrammatic dictum,
“The working man has no time to be an early case
of tuberculosis”; thus the sanatorium was prone to
become a hospital for incurable cases, and at the
best it arrested the progress of the disease but did
not cure. Hence when, after some months in a sana¬
torium, the worker returns to his home and the severe
competition with healthy men, a relapse is only too
likely to occur sooner or later. The ideal of Papworth
is that after sanatorium treatment the tuberculous
patient should pass into a settlement or colony
where, while under skilled supervision, he can earn
a living by a properly restricted activity suited to
his diminished capacity. Later in the year Allbutt
headed the signatories of a letter of appeal for sub¬
scriptions for a portrait bust in bronze of Woodhead;
this is now in the Pathological Department of the
University. There is also a memorial at Papworth in
the form of the Woodhead Laboratory.

On January 20 he gave an address of a religious
character to the Student Christian Movement, with
the following conclusion:

And now, my younger friends, let an old man leave this
message with each one of you. There are times in the lives
of all of us when the flame of the Spirit burns low; we are
out of heart; we hardly know what to believe; the evil in
the world dejects us, or, which is worst of all, we drift into
indifference; the lamp drops from our hands; and, if we

263

SIR CLIFFORD ALLBUTT

watch ourselves as we ought to do, we find we are losing the 1922
finer edge of our kindliness, our truthfulness, our purity. In
these cold and arid seasons the message is, keep right on in a
steady faithfulness, hoping all things; and in a while, a few
weeks it may be, or in days, perhaps even in a few hours, a
light, a sudden light, as of the presence of God, will shine
again within you, and once more you will return into that
peace which passes all understanding.

In a general review of the subject, entitled “A Dis¬
cussion of Angina Pectoris”,1 published in February,
he considered the various hypotheses, and amongst
them that put forward by the late Dr. H. Walter
Verdon, who in his book on the subject (1920)
described his own symptoms, thinly veiled, as those
of “Dr. X”, and argued that the disease is due to a
disturbance of the nervous mechanism of certain
spinal segments by peripheral irritation arising not
in the heart, but usually in the stomach. With regard
to the treatment by nitrites, Allbutt, who in 1908
(vide p. 188) had expressed some fear that a nitrite
habit might result, now did not find any reason to
believe that a morbid craving was thus engendered.

His interest in post-graduate teaching was shown
by his contribution of a philosophic preface to a
volume of post-graduate lectures organized by the
Fellowship of Medicine and delivered at the house of
the Royal Society of Medicine. In May he was elected
a F oreign Honorary Member of the American Academy
of Arts and Sciences (Boston, Mass.).

In “The Times” of March 4 he and Dr. P. C.
Varrier-Jones, Medical Director of Papworth Colony,
wrote a letter with the heading “The Problem of

1 New York Med. Journ. arid Phila. Med. Journ., N.Y., 1922,
cxv. 181-87.

264

SIR CLIFFORD ALLBUTT

1922 Tuberculosis: Is our Expenditure Wasted?” pointing
out the danger of the cry for economy in public
health, and that a recent circular (No. 280) of the
Ministry of Health would tend to perpetuate the mis¬
take of wasting a large part of the present expendi¬
ture on the treatment of tuberculosis. The sane
policy, they insisted, was prevention, and in order
to stamp out the infection at its source, the whole
family of a tuberculous patient must be looked after.
The success of the Papworth Colony was instanced
to show that this can be done. This was followed up
early in July by their article1 on “Further Experi¬
ences in Colony Treatment and After-Care”, in which
the existing conditions of the sanatorium treatment
of tuberculosis were held up to grave criticism on
the same lines as in a small book published after
Allbutt’s death ( vide p. 261). From it a striking para¬
graph may be reproduced here:

The lay mind has always desired and looked out for
direct “cures” for every disease. The word “cure” acts as a
spell; it obscures and throws into the background all
questions as to the origin of disease. For most people pre¬
vention has far less fascination than “cure”. Hope is stirred
to the depths by the report of a “cure” for consumption,
though a report of prevention leaves most people cold; we
wish to consider ourselves immune to every disease, until we
are struck down.

At the meeting of the British Medical Association
at Glasgow, where in 1888 he gave the address in
Medicine, the Gold Medal of the Association “for
distinguished merit” was awarded to him for “dis¬
tinguished services to the profession and to the
Association, and in commemoration of his five years’

1 Lancet, 1922, ii. 105-8.

SIR CLIFFORD ALLBUTT 265

Presidency of the Association at the time of the 1922
Great War”. He was actually President during the
years from 1915 to 1920 inclusive, instead of for the
usual period of one year. The Medal was accompanied
by an address, written by the editor of the British
Medical Journal, the late Sir Dawson Williams,
beautifully illuminated by Mr. (later Sir) Frederic G.
Hallett, and inscribed on fifteen pages in a volume
bound in rich brown morocco leather and hand-
tooled in gold. The illustrations included sketches
of Gonville and Caius College, “the Backs” and other
views of Cambridge, a corner of Park Square, Leeds,
of Windermere, the Swiss Alps, and the Arms and
Crest of the Regius Professor of Physic. On the even¬
ing of July 25, the President of the Association, the
late Sir William Macewen, presented Allbutt with this
Medal, which was instituted in 1877 to be awarded
on the recommendation of the Council to “some
person who shall have conspicuously raised the char¬
acter of the medical profession by scientific work, by
extraordinary professional services, or by special
services rendered to the British Medical Association”.

In the Section of Pathology (Human and Compara¬
tive), a discussion on animal pathology in relation
to human disease was opened by Professors F. Hob¬
day and W. H. Lang, after which the President of
the Section, Professor R. Muir, called upon Sir Clifford,
who then urged that no scientific subject could ad¬
vance without the comparative method, and in¬
stanced history, philology, anatomy, physiology —
even religion — as indebted to this method for much
of their accumulated and systematized knowledge.

The negligence of this method by human nosologists
had sterilized not only their own work, but that of

2GG

SIR CLIFFORD ALLBUTT

1922 veterinary and plant pathologists. Arguing by ana¬
logy, he went on, had been the bane of medicine from
its birth, and affinities and origins must be sought as
far back as possible in the animal scale.1

To the Educational Number of the British Medical
Journal on September 2 he wrote on the training of
the medical student, and insisted that the three
fundamental principles of all professional educations
were: first, good general education; secondly, a good
scientific education; and thirdly, a good technical
education, and that in the case of medicine, these
three occupy more than a quarter of the individual’s
life. Further, the division of the profession into two
classes — those in general practice and medical scien¬
tists who advance professional knowledge, represented
respectively by the qualifications of the diplomas
of the licensing bodies, such as the Conjoint Examin¬
ing Board in England, and by the degrees of the
Universities — carried with it the necessity of training
longer for the scientific man by one-half than for the
practical family doctor. While recognizing the genuine
need and value of specialization, he deprecated this
at the expense of a good general knowledge of medi¬
cine, and pointed out that at Cambridge special
diplomas were granted for subjects, such as tropical
medicine and public health, lying outside the medical
curriculum, but not for those belonging to the ordi¬
nary course of instruction, such as ophthalmology
and tuberculosis.

On October 2 he gave, for the second time, the
first being in 1889, the introductory address at his
old school, St. George’s Hospital, and spoke on
“Medical Education, Past and Present”.2 Beginning

1 lirit. Med. Joarn., 1922, ii. 9G1. 2 Lancet, 1922, ii. 781.

2G7

SIR CLIFFORD ALLBUTT

in a reminiscent vein, which he regarded as a sign of
age, he recalled his teachers at the hospital when
Oxford and Cambridge men were not supposed to
compete against the ordinary students for resident
posts or even for prizes; this explains, what might
otherwise seem remarkable, why he was not a resi¬
dent or a prize-winner there. He then spoke of pro¬
fessional training in somewhat the same terms as in
his recent contribution to the Educational Number
of the British Medical Journal, and sternly condemned
the practice of psycho-analysis, as he had done in his
presidential address to the British Medical Associa¬
tion at Cambridge in 1920. It “has been known”, he
said, “for centuries in the Church as confession and
casuistry, and the Roman Church has been well aware
of its dangers”. To his highly cultivated mind and
fastidious taste, the discussion of sexual matters was
naturally repulsive, and he abstained from taking a
public part on either side in the questions of the
combating or the prevention of venereal disease, and,
except in his address at Bradford in 1903, was silent
about birth control. He concluded on the more pleas¬
ant note of the “Rewards of the Doctor”, and advo¬
cated the cultivation of a hopeful outlook. A success¬
ful physician once told him that he never left a house
without giving a favourable prognosis, a practice
which, though with a colour of worldly wisdom, was
right in “that no one could foresee what benediction
words of hope might bestow”. This good motive
certainly characterized his own ministrations to the
sick, and also those of his brother Regius, Sir William
Osier. On October 26 the Allbutts sustained the loss
of their neighbour, the Reverend H. S. Cronin, the
husband of their niece and adopted daughter, whose

268

SIR CLIFFORD ALLBUTT

1922 marriage took place in 1899 ( vide p. 141). He wrote
on November 18 to Lieut. -Colonel F. H. Garrison:

How splendidly you do these things! I am so thankful
for your great paper on the History of Military Medicine, as
otherwise I should never have seen it. Thorough as well as
comprehensive, it must stand out as a permanent contri¬
bution to medical history. The scattered and partial articles
on the subject needed to be again reviewed, consolidated,
and represented. It was very enterprising too to have under¬
taken to include the Great War! — hardly yet at an end. The
narrative is charmingly readable.

It is always a great pleasure to me to think, if we cannot
meet on your side (I look forward to a visit here from you),
I have so cordial and interesting a friend in the New World.

At this time he accepted the position of President
of the West London Post-graduate College, where his
lectures on “kinds of pneumonia” and angina pectoris
had attracted large and appreciative audiences.

Sixty-jour Years a Doctor: The Reminiscences of
Sir Charles Brown, an Octogenarian Lancashire Doctor
(1922) was dedicated “to Sir Clifford Allbutt, whose
Pathway through life from 1836 to 1922 has been
concurrent with my own”. Known as “the Grand
Old Man of Preston”, Sir R. C. Brown was a be¬
liever in the therapeutic power of music in neur¬
asthenia and in furthering convalescence, presented
organs to the Infirmary and other institutions in
Preston, gave an address to the Fylde Medical
Society on “Music and Medicine”( 1894), and was of
opinion that most men remarkable for longevity
have been fond of music. Towards the end of his long¬
life he said that he had “found the value of money
now that he was giving it away”; influenced by
Allbutt, he was, as already mentioned, a generous

SIR CLIFFORD ALLBUTT

269

benefactor to the Cambridge Research Hospital, which
in 1928 took the name of the Strangeways Research
Laboratories. Born in the same year, BroAvn died on
November 23 in the same year as Allbutt. The suc¬
cessful Textbook of the Practice of Medicine, edited by
Dr. F. W. Price, was also dedicated to Sir Clifford,
and the second edition in 1926 to his memory. In the
following year Dr. J. F. Halls Dally, who, like Dr.
Price, was connected with Mount Vernon Hospital,
dedicated his book on “High Blood Pressure” to the
describer of hyperpiesia.

1923

Under the pseudonym of “Grammatista” 1 he sup¬
ported the proposal that instead of the names
“woman doctor” and “lady doctor” the prettier one
of “doctress”, thus following the example of Italy,
should be adopted. Early in the year the third
edition of his Notes on the Composition of Scientific
Papers came out; in obedience to a general wish the
peculiarly scientific features of the first edition were
modified, and, while preserving their immediate pur¬
pose, many of the medical instances were exchanged
for others of a pleasanter nature. A former Cambridge
pupil, who had taken up medical literary work, in an
appreciative review2 justly remarked: “Rigorous re¬
vision has cast out some familiar passages which
many will think too good to lose. Remembering its
purpose few would have grumbled had the book
grown with the passage of time. ... If we should
seem to write of it with too much enthusiasm we

1922

1 Brit. Med. Journ., 1923, i. 129.
2 Ibid., 1923, i. 422.

270

SIR CLIFFORD ALLBUTT

1923 reply that the medical editor by the nature of his
work feels more often than others the need of such
advice.” Allbutt then wrote to the editor, the late
Sir Dawson Williams: “If it is unusual to thank the
editor for kind appreciations I must for once dis¬
regard conventions, and express my warmest grati¬
tude for the most generous review this week of my
little Compositions book. I feel the kindness more as
the reviewer has evidently read this book — a rare
attention! It made my wife very happy.” Possibly
in the last sentence but one Sir Clifford had in mind
Sheridan’s mot, “You should never read a book
before reviewing it, as it prejudices you so!”

In February he joined in a correspondence in the
Cambridge Review on bell-ringing, which he said was
now so altered that skilled change ringing had be¬
come a lost art, and referred to his recollections of
bell-ringing competitions at Dewsbury in his youth
(vide p. 6). When he returned to Cambridge in 1892
it seemed to him that the quarter chimes of Great St.
Mary’s had “lost something of their charm, a loss that
seemed difficult to explain. As I listened, I thought
the rhythm had hardened; that in the course of re¬
pairs some soulless mechanic had distributed the
intervals equally; while in my earlier time they still
retained that little wilfulness of chime, that human
touch, which the original artist had given to them?
‘A little less and how far away.”’ In a letter1 to the
medical press on March 6 Allbutt gently questioned
Dr. J. S. Haldane’s use of the word “mechanistic” in
place of “mechanical” and raised a protest, as did
John Sterling in reproaching Thomas Carlyle for its
use nearly ninety years before, against the “word
1 Bril. Med. Journ., 1923, i. 441.

SIR CLIFFORD ALLBUTT

271

environment as ugly and ineffectual”. A case of hyper- 1923
piesia reported by Dr. D.C.L. Vey1 in the same Journal
was supplemented by a commentary from the original
describer of the condition. On May 4 he addressed the
Cambridge Medical Society on the “Diagnosis and
Treatment of Angina Pectoris”,2 insisting on his view
that the underlying cause was in the first part of the
aorta, and referring to the supporters of his conten¬
tion, among them Professor K. F. Wenckebach, who
in the following year came over to this country to do
so in a special lecture before the Royal College of
Physicians of London. The interest excited by this
paper led to a correspondence in the pages of the
Lancet. In June he related3 how he came to the con¬
clusion that arteriosclerosis is not the cause of raised
arterial blood-pressure. Incidentally he mentioned
that when sitting on a Home Office Committee (1906-
1909) he was able to confirm the occurrence of a local
arteriosclerosis in the limbs of men engaged in hard
labour, adding that this change was of little import¬
ance, and was not evidence of a similar general arterial
change. Some observers, he said, attached far too
much importance to small differences, such as 10
or even 15 mm. of mercury, in the blood-pressure;
the best “symptomatic” treatment was the high-
frequency current, and a most important point was
to free the patient from apprehension about his con¬
dition.

The eight hundredth anniversary of the Founda¬
tion of St. Bartholomew’s Hospital and the Priory
Church of St. Bartholomew the Great was celebrated
on the four days, June 5-8, and naturally Allbutt

1 Allbutt, C. and Vey, D. C. L., Brit. Med. Journ., 1923, i. G72.

2 Lancet , 1923, i. 893. 3 Am. Med., 1923, p. 345,

272

SIR CLIFFORD ALLBUTT

1923 was the delegate appointed to represent the Univer¬
sity of Cambridge. The sixty-five delegates presented
addresses of congratulation, each speaking for two
minutes, and the Governors of the Hospital marked
the occasion of the octocentenary by striking a medal
bearing the heads of William Harvey and Raliere
the Founder, and by printing a short history of the
Hospital, written as regards the past and present by
Sir D’Arcy Power, and as regards the future by Sir
Holburt Waring.

On June 19, at the annual dinner of the West
London Medico-Chirurgical Society, when presented
with the Society’s Triennial Gold Medal, he modestly
disclaimed any title to honours such as this and
others — the Moxon Gold Medal of the Royal College
of Physicians (1921) and the British Medical Asso¬
ciation’s Gold Medal of Merit (1922)— but happily
supposed that “his professional brethren had come to
look upon him, in Bismarck’s phrase, as an ‘honest
broker’ in the mart of medical ideas and discoveries,
acting as a merchant between producer and con¬
sumer”. After briefly reviewing the recent changes
and advances in medicine he concluded: “We are
living thankfully in a glorious time; our children will
go much further still, but they will owe much of their
progress to the principles laid down by the great men
of our own times”.

A few days later he wrote the following letter to
Dr. F. G. Crookshank, who had the same strong feel¬
ing for the accurate use of words and clear thinking:

St. Radegunds, Cambridge,
June 27, 1923.

I have just received a copy of the Medical Press and
Circular containing your very able article on “Meanings”.

SIR CLIFFORD ALLBUTT

273

It seems to be a continuation from a part (I.?) which has 1923
escaped my notice, although the Editor a while ago devoted
a long article to my little book which was indeed worth
living and writing for. I am especially pleased now by your
tilt at “morbid entities”. I am tired of asking my pupils —
on their essays — where the entity is? It is funny to see how
they are taken aback, and puzzled. ... A worse error is
almost universal — the calling of opinions, postulates and
general statements (axioms — rules, principles, and laws) by
the name of “facts”. I have jabbed at this in my little book
— 3rd Edition. Have you a copy of the third edition? If not,
may I send you one?

On July 4, 1923, he went down to Lord Mayor
Treloar’s Cripples’ Hospital and College at Alton in
Hampshire, of the Honorary Medical Board of which
he had been a member since November 28, 1911, and
delivered a masterly address 1 to the Queen Alexandra
League on the ideals of the work done there, quoting
with approval the dictum of the late Sir Anthony
Bowlby, then President of the Royal College of Sur¬
geons, that “the glory of Alton is that it has abated
surgery; that it does surgery without surgery”. He
applauded Sir Henry Gauvain’s attitude of “back
to Hippocrates” and the vis medicatrix naturae, the
utilization of the healing power of light carried out at
Alton and Hayling Island, and the therapeutic value
of the educational methods. In conclusion he said:

“In speaking especially of Alton, may I play on an
old string of mine, nay on two: First, may I rejoice in
the remarriage of surgery and internal medicine, the
divorce of which has been one of the chief banes of
Medicine during the long period of its history; and
secondly, on the establishment at last in my own
university of an Institute for Comparative Medicine

1 Brit. Med. Journ., 1923, ii. 111.

T

274

SIR CLIFFORD ALLBUTT

1923 in which the study of the diseases of many kinds of
animals will throw mutual lights upon those of each;
as you know, tuberculosis is a disease common to man
and many animals”. Before the address he planted
an oak tree, which now has a plate with an inscription
recording the event. At the lunch with Sir William
Treloar and Sir Henry Gauvain he was in great form,
and there was much genial chaff between the two
veterans.

In August and September Allbutt was in North
Wales and wrote to Lieut. -Colonel F. H. Garrison:
“I am now engaged on a new scheme, a course of
lectures in Cambridge on the history of Medicine;
first a general scheme; then to take up periods more
intensively. I can do this quite well besides my
regular professional work, especially as I have ‘Garri¬
son’ always at my elbow.” The following letter to
Professor Harvey Cushing of Boston, Mass., was in
reply to an inquiry about the late Sir William Osier
on whose Life he was still engaged:

St. David’s Hotel,
Harlech, North Wales,
Sept. 4, 1923.

Dear Dr. Cushing,— It is delightful to have a little
missive from you; but I wisli I could say more on the point
of William Osier’s generous and modest reticences on his own
works and published opinions. Although I noticed it many
times, yet these were fugitive instances, hard to pin down.
One small point does remain in my mind because it put me
to a little shame. On some public discussion I had declaimed
about angina pectoris that it was no uncommon disease if
one included mild degrees of it. I described a mild form and
so on. W. Osier was there and spoke also, in agreement,
never mentioning any work oi his own. Some weeks latex I
turned up angina pectoris in W. Osier’s last edition, and to

SIR CLIFFORD ALLBUTT

275

my dismay found that he had formally divided angina
pectoris into (four?) divisions (I write away from books) of
which No. 1 was my “Angina Neuritis”. I say to my dismay,
because I might have seemed to him to be a poacher? Or
was I overawed by his magnanimity? A little of both. But
such minor points as these cannot be formally recorded—
they are too unsubstantial. We were delighted to see W. W.
Keen again, so vivid and full of life and fun. Yes, W. Osier
stopped many a time with us. For 3 (?) years he was an
examiner in Cambridge (as Garrod is now), i.e. he stayed the
inside of a week with us twice yearly, besides casual visits
from Baltimore days onward (when you and Futcher were
next door), and we were often with him and Lady Osier.
Indeed we lately spent a few days with her. I fear I have
nothing in the way of relics.

His intellectual activity was obviously shown in
his scholarly criticism in the Classical Review 1 of
Henry Osborn Taylor’s Greek Biology and Medicine
and Charles Singer’s volume on the same subject; he
threw out a warning in the question —

Does the passion for history and archaeology, in our day
so general, signify a waning of creative genius, a looking
back of men, not pressing forward to new ideals?

Without definitely giving an answer he went grace¬
fully on:

The history of the day is inspired by the methods of
natural science, which itself indeed is a kind of history, but
more analytic and adaptive than creative. At any rate, we
may be thankful that our history is good, and that good
history is being served out to the public in portions as
wholesome and digestible as the two little books before us.

Early in October a long and considered review of
Dr. A. D. Ritchie’s book, The Scientific Method: An

1 Classical Rev., London, 1923, xxxvii. 129.

1923

276

SIR CLIFFORD ALLBUTT

1923 Inquiry into the Characters and Validity of Natural
Laws, appeared over his initials,1 and a paper in col¬
laboration with P. C. Varrier-Jones, the Director of
the Cambridge Tuberculosis Colony at Papworth,
near Cambridge, was published on “Village Settle¬
ments for the Consumptive: Some Economic Con¬
siderations of ‘Training’,” 2 a subject which they sub¬
sequently treated in book form. The following letter,
written on October 10, to T. R. Glover, D.D., the
Public Orator, shows his artistic feeling and keen
interest in classical scholarship:

Two days ago, having an hour to spare in the Athenaeum,
I fortunately lighted upon your delightful Virgil (I was
pleased to see you knew how to spell Virgil in English, as
you do Terence and Livy). It is a charming study. But I had
one rather nasty shock where you describe Menalcas as
watching and piping with his young woman in his arms,
reminding one of the Bishop of London s desciiption of
Hyde Park! I have turned up Lang’s translation and I see
that he gives the same rendering. Theocritus has his marks
of decadence no doubt, but this picture is too unhellenic. . . .
It had never entered my head that the enclitic tv meant
other than his pipe, for which the bent arms are most
characteristic and artistic. The young woman view is clumsy
and inartistic. Theocritus is dwelling on the picture watching
and piping and gazing at the sunny sea. No young woman is
mentioned. . . . But I fear you are all against me still I
think you are all wrong! The shepherds’ pipes are the burden
of the whole idyll. The young women (or one only) are very
allusive. Do try to think how much more pastoral and
exquisite my view is. It is odd if I am alone in this, as I
never thought of any difference ol opinion.

On October 20 he wrote a short letter3 recommending
the spelling “deinosaur” in preference to “dinosaur”,

1 Brit ■ Med. Journ., 1923, ii. Oil. 2 Lancet, 1923, ii. 912.

3 Nature, 1923, cxii. 590.

SIR CLIFFORD ALLBUTT

277

a question that had been raised in the pages of 1923
Nature.

On October 24, as the first President of the new
Section of Comparative Medicine at the Royal
Society of Medicine, he gave the introductory ad¬
dress on “The Integration of Medicine1”, pointing
out that as physic had been divorced from surgery
and mind from body, so were the diseases of man
from those of animals, and continuing in picturesque
simile: “The folly of the division of the medicine
of the hand from the medicine of the bottle has now
become so glaring that our next festival may be on
the blowing up of this rampart; indeed the gynaeco¬
logists have exploded their end of it already. But it
is a big business to transform a mediaeval castle,
with its baileys, barbican, and keep into a modern
domain.” The first and the last sentences in his
address seem to express his philosophy of life’s work:

“If for years slowly and almost silently our work
makes its way we must be content; our experience
of the world teaches us to be content; but happily,
now and then, after long hewing in the dark forest,
we break into the light; we find ourselves almost
suddenly upon a peak, our way open and bright
before us, and our cause justified before men. Such
a festival is our meeting to-day.” And in conclusion
he quoted Benjamin Franklin’s dictum, “Hard work
is still the road to prosperity, and there is no other”.

Sir D’Arcy Power,2 a successor of his in the chair
of this Section, in his presidential address spoke of
him as a reincarnation of Conrad Gesner (1516-1565)
of Zurich, who in his Historia Animalium dealt at

1 Proc. Roy. Soc. Med., 1923-24, xvii. (Sect. Comp. Med.) 1-3.

2 Ibid., 1 92(i, xx. (Sect. Comp. Med.) 87.

278

SIR CLIFFORD ALLBUTT

1923 large with the habits and diseases of animals, was
certainly one of the best beloved men of his time,
and had the same encyclopaedic mind. Osier, who
often spoke of Gesner as “a great friend”, has also
been regarded as his modern double, and thus again
the two Regius Professors appear as brothers in the
eyes of those who knew them best.

In “The Times” of November 1 there was a letter
over his signature on “the Medical Panel”, showing
that the payment should be considered in reference
to the services rendered and the cost involved in
becoming a medical man under present conditions.
Medicine, he pointed out, has been not so much
changed as transformed; a generation ago the doctor
was an observer and a naturalist, and by practice
mainly an empiric; now medicine was being recon¬
structed and general practice was thus rising in value
and consideration; Cambridge M.B.s, who in his
young days all aimed at consulting work, were now
going into general practice.

On the death of Mr. T. Pridgin Teale on Novem¬
ber 13, 1923, in his ninety-third year, he paid an
eloquent tribute1 to a friend of more than sixty
years, mentioning that he was the first surgeon, or
one of the first, "to provide a nursing home for his
private operations, an innovation far from popular
at the time, as the general practitioner thus lost the
post-operative care of the patient. In describing the
man he said that Teale “thought with his fingers”.
They were associated in very early days at Leeds
in experiments on the hypodermic injection of mor¬
phine, and later in the operative treatment of tuber¬
culous glands in the neck. The obituary notices in
1 Bril. Med. Journ., 1923, ii. 1007.

SIR CLIFFORD ALLBUTT

279

the Proceedings of the Royal Society and in Nature were
also from his pen, and in the former he mentioned
that their collaboration in experimental pharmaco¬
logy was cut short by the Anti-Vivisection Act when
they had only discovered the remarkable immunity
of rabbits to morphine. He also wrote a sympathetic
appreciation of Dr. William Hall (1834-1923) of
Leeds, whom he remembered in his own early days
at Leeds, when he himself “was living chiefly on
hope”, as one of the first to move in the provision
of “school meals”. Hall was the senior partner of
Mr. (later Sir) A. Mayo Robson, who in early days
confided to him (T. C. A.) his ambition to risk all in
the pursuit of pure surgery. In a letter1 published
in December he recalled his advocacy in 1869 of
hypodermic injections of morphine for the relief
of the dyspnoea of cardiac disease. The Michaelmas
number of the Cambridge University Medical Maga¬
zine, belonging to the Medical Society of the under¬
graduates working at medicine, appropriately con¬
tained an interesting “Message to Medical Freshmen”,
full of the ripe wisdom and experience of the Regius
Professor of Physic. He begged men to keep up their
literary tastes, and gave them the advice on which,
it would seem, his most active life had been based:

Never waste — even five minutes; always have something
on your desk that you can do between lectures, before hall,
and while waiting for a friend. Finish everything up as you
go; leave no loose ends. Never rest, except in sleep; change
your occupations.

1923

1 Lancet, 1923, ii. 1422.

280

SIR CLIFFORD ALLBUTT

1924

1924

As an appendix to the case presented on behalf
of Insurance Practitioners by the Insurance Acts
Committee of the British Medical Association, before
the Court of Enquiry into the Insurance Capitation
Fee, Allbutt made a statement1 with regard to con¬
tract practice; he pointed out that the time required
for a full examination of a fresh case — let alone skill
and elaboration— is at least double what it was
fifteen years previously, and the remuneration then
sufficient had therefore become inadequate, and
that in the long run, even among honourable men,
scanty pay must bring about a lower grade of service.
The necessary training of a medical man was much
longer than it was a generation before, and the pres¬
ent day family physician must go through all the
special departments far enough to realize their
bearings and so to advise his patients properly.

In the Lent term he published in the newly estab¬
lished Cambridge University Medical Society Maga¬
zine the first of three lectures2 on the History of
Medicine, dealing with the Hippocratic, the Alex¬
andrian, and the Graeco-Roman periods, the last
appearing after his death. A leader in “The Times”
of March 1, entitled “What makes a Lunatic?” in
connection with the Harnett case, gave rise to some
correspondence in its columns about the evidence
of insanity and criminal responsibility; in this Allbutt
joined on March 6, and, after pointing out that
“health whether of body or mind is not a fixed posi¬
tion or rotation, but an oscillation about an ideal

1 Brit. Med. Journ., 1924, i. supplement, p. 5.

2 Cambridge Univ. Med. Soc. Mag., 1924, i. 209; ii. 9; 1925, ii. 114.

SIR CLIFFORD ALLBUTT

281

axis", concluded from his experience of the insane,
both as an old visiting justice and as a physician,
that there was not much real difficulty in coming
to a decision between insanity and sanity.

In April 1924 the Allbutts went to the Lakes and
stayed for two weeks at Ambleside, being fortunate
in getting good weather for what was his last visit.
Mr. C. H. Hough of White Craggs, Clappergate,
Ambleside, wrote to the late G. E. Wherry, who
contributed the obituary notice of Sir Clifford to the
Alpine Journal (1925, xxxvii. 176-79), an account
of Allbutt’s “walk over Loughrigg, 1000 ft. above
Windermere, last spring, when he was ‘eighty-eight
if I live to July’. The expedition led over streamlets
and rocky slopes with occasional stone walls, and
he enjoyed every bit of it, quoting ‘Long hast thou
been a darling haunt of mine’. His eagerness was
delightful, and on a sunny day”, writes Mr. Hough,
“I called at his lodgings in the morning; Lady Allbutt
met me with the remark, ‘Oh! he has started off
alone; he thought you were detained’. On the way
Allbutt pointed out the distant tops, all of which he
had climbed in his time. I left him in Ambleside,
thoroughly delighted with the expedition and show¬
ing no apparent fatigue.’ In December Sir Clifford
wrote: ‘This walk I fear will never be repeated. We
are both well, I am very well, but cannot walk far;
we have, therefore, not yet discussed a possible
journey to the Lakes for next Easter. I shall then be
near the entrance to my ninetieth year and we may
shrink from a long journey. And I could do no
more than look at the hills — still that would be
something .’”

To Imperial Health, the Report of the First Inter-

1924

282

SIR CLIFFORD ALLBUTT

1924 national Conference of the People’s League of Health,
held at the British Empire Exhibition, May 21-24,
he contributed the Foreword. The League was con¬
gratulated, for its object— the education of the pub¬
lic — was much more needed than legislation, which,
when pushed beyond popular understanding, did
more harm than good; “only perhaps in the matter of
mental diseases, and of codification, is new legislation
really urgent”. In speaking of the habits of artificial
civilized life, he remarked, “It is curious that none
of the speakers touched on tobacco; perhaps they
were all smokers, and the point was a tender one;
but it is difficult to suppose that so potent a drug
can be wholly indifferent to our bodies. At least, as
I have said elsewhere, smoking cigarettes adds ten
more years to the record of age upon a woman’s face
— which is a pity.” Among a number of other idio¬
syncrasies ( vide p. 294) Allbutt was very susceptible
to tobacco smoke, an account1 of which he gave in
1897 without betraying his identity: “One case is
known to me of a man whose general health is excel¬
lent, who is by no means a neurotic subject, and
whose heart stands work well in all other respects,
in whom intermittence of the heart may occur for
many days if he remain for an hour or two in a room
with many smokers. He dare not sit in the smoking
room of his club or in the smoking compartment of
a railway carriage. The intermittence may not begin
until the next day, or the next but one, but then
comes on with the certainty of a laboratory experi¬
ment; it gets worse during the next day or two, and
then gradually passes off in a few more days. He
never suffers from any cardiac disorder unless ex-

System of Medicine (Allbutt), 1897, ii. 915.

i

SIR CLIFFORD ALLBUTT

28.3

posed to tobacco, but this proclivity has hung about
him for many years. He has no dislike to the drug,
nor does he feel any immediate discomfort from it.”
Though a non-smoker, and obliged as far as possible
to avoid long public dinners, he was extremely broad¬
minded on the subject, always offering his guests
cigarettes, and the most forcible indictment he ever
made against it was that it aged feminine beauty.
In a review1 of the relation of smoking to arterio¬
sclerosis in 1915, he came to the comforting conclu¬
sion that if it is a cause at all of arteriosclerosis, it is
a very slow one, at least to most persons, so that its
effects being mingled with other conditions of senility
are almost impossible to identify, and in his post¬
humous Arteriosclerosis: A Summary View he did not
find any later evidence to modify his opinion that
the effect of tobacco in causing hyperpiesia and senile
atheroma, if any, is negligible.

In the course of a sympathetic obituary notice2 of
Thomas George Bonney (1833-1923), who had been
President of the Alpine Club (1881-83), he wrote:
“When, on his return to Cambridge in 1905, the
Cambridge Branch of the Alpine Club was founded,
Bonney was caught in the act of proposing as the
first President a friend of not half his own quali¬
fications for the honour. The Club soon put that
right.” It is not difficult to guess who the “friend”
was.

In connection with a discussion on pulmonary
embolism and primary pulmonary thrombosis held
by the North of England Obstetrical and Gynaeco¬
logical Society at Liverpool on March 14, he wrote

1924

1

Diseases of the Arteries including Angina Pectoris, 1915, i. 250.
2 Alpine Journal, 1924, xxxvi. 142-47.

284

SIR CLIFFORD ALLBUTT

1924 a letter1 giving details of his experience of these con¬
ditions, and making public for the first time the
nursing precautions he had successfully employed
for the prevention of femoral thrombosis in typhoid
patients when he was in entire charge of the Leeds
Fever Hospital in the ’sixties ( vide p. 32). Concern¬
ing the clinical distinction between pulmonary embo¬
lism and thrombosis there was, he thought, rarely,
if ever, any difficulty, for the onset of symptoms in
embolism was absolutely sudden, whereas “throm¬
bosis, rapid as it may be, is gradual”, and in support
of the latter sequence he described a case seen a few
years before.

On May 5 Professor Karl Friedrich Wenckebach,
Director of the First Medical Clinic in Vienna since
1914 and widely known before the War for his cardio¬
logical work at Groningen, gave a special lecture 2 at
the Royal College of Physicians of London on “Angina
Pectoris and the Possibilities of Surgical Relief”, a
subject for which his ten years’ experience of Vienna,
with its trying conditions, had afforded unusual oppor¬
tunities for investigation. Though such special lectures
are exceptional at the College, which has almost an
embarras de richesse of endowed annual lectures, the
subject and the occasion rendered this one particu¬
larly appropriate; the first real account of the disease
was given at the College on July 21, 1768, by William
Heberden, the elder, on the basis of twenty cases, in a
paper entitled “Some Account of a Disorder of the
Breast”, and other Fellows of the College had been
prominent in the investigation of a disease which,
therefore, is specially associated with British Medi-

1 Lancet, 1924, i. 872.

2 Brit. Med. Journ., 1924, i. 809-15.

SIR CLIFFORD ALLBUTT

285

cine. Prominent among the moderns were Allbutt 1924
and James Mackenzie, both then in the last year
of their lives. Mackenzie was stricken with this — the
Doctor’s — disease and could not be present; but
Allbutt was there to hear Wenckebach’s enthusiastic
support of his view that disease of the first part of
the aorta was the essential factor, and that changes
in the coronary arteries and the heart muscle were
of secondary importance in the causation. Wencke¬
bach said that his chief motive for making this com¬
munication to his professional brethren in England
was his possession of the strongest experimental
proof of the correctness of the contention of “the
best authority on angina pectoris of this time — your
highly honoured, even right honourable, Nestor of
teachers of Medicine, my faithful friend in sunny and
in dark years, Sir T. Clifford Allbutt”. After this
lecture by Wenckebach, who in 1928, at the tercen¬
tenary of William Harvey’s publication of the Exer-
citatio anatomica de Motu Cordis et Sanguinis in
Animalibus, was, in accordance with a new by-law
(1927), made an Honorary Fellow of the College at
the same time as Lord Balfour, Professor I. P. Pavlov,
of Petrograd, and Sir Ernest Rutherford, President
of the Royal Society, the large audience had the
pleasure of hearing Sir Clifford 1 express his “satis¬
faction that certain hypotheses concerning angina
pectoris which I have propounded to rather deaf
ears for five-and-thirty years have now received con¬
firmation from a supreme judge”. He spoke with the
vigour and clearness that many a man of half his
years might envy. This was the last occasion that he
attended a meeting at the College.

1 Brit. Med. Journ., 1924, i. 828.

286

SIR CLIFFORD ALLBUTT

1924 In May he wrote this appreciative letter to Lieut. -
Col. F. H. Garrison:

St. Radegunds, Cambridge.

I have just given the last of a short course of University
Lectures here on the history of medicine and I seize the first
spare moment to thank you most cordially, most pro¬
foundly, for the extraordinary service of your great book. It
is one thing to use such a book casually as a work of refer¬
ence, it is another to have to use the ivhole book for intimate
and general preparation. Every day I was more and more
astonished at its fulness and completeness in detail, and yet
I had Haeser, Neuburger, Pagel, etc., all at my elbow. How
you collected all your detail, and never missed a date that
one wanted, is a mystery. The book must have cost you
years of time. And there is so much good reading in it — -not
mere dry chronicles. And I hope you are well and family
happy in spite of your banishment from your dear library
where the world wants you to be again. We are all well and
things going slowly back to pre-war, but still trade short
and prices high. If there can be a fault in your book it is
your too kind but very acceptable courtesies to me.

On June 27 he presided at the Cambridge Gradu¬
ates’ Medical Club, which held their annual dinner in
the hall of Trinity College. In the summer he was
engaged in a correspondence1 with Professor G. M.
Robertson, Sir James Barr, Dr. R. D. Rudolf, and
others in the medical press about the cardiac delirium
which he had described in 1885, nearly forty years
before ( vide p. 90). His love of natural history made
him write to “The Times” urging, as in the case of
lapwings, that steps should be taken to protect swal¬
lows, the numbers of which had recently much
diminished; this letter appeared on July 4. In another
short letter in the same journal on July 24 he quoted

Brit. Med. Joum., 1924, i. 1154; ii. 130, 343.

1

SIR CLIFFORD ALLBUTT

287

with approval a letter written in 1886 by the late 1924
Canon Westcott on the Sacrament. In August and
September the Allbutts were on the Yorkshire moors,
and when at Whitby he had warnings that his marvel¬
lous health was breaking, for on walking uphill and
sometimes even on the level he was occasionally
pulled up with oppression, and on one occasion so
severely that he thought his last hour had come. This
disability increased, and in October he could not
walk a quarter of a mile, but appeared well to others
and kept his own council, though recognizing that
unless improvement occurred his career must close.

He was back in Cambridge on September 16, when a
short letter from him appeared in “The Times” in
connection with a discussion about a motto for Lon¬
don; he suggested that the most appropriate was that
already its own — the old Roman name Augusta.
Later in the year he wrote a grateful appreciation of
the late Dr. G. E. Haslip, who was treasurer of the
British Medical Association from 1916, and had been
the first to propose that Allbutt’s portrait should be
painted and presented to him at the Cambridge
Meeting in 1920.

The following letter to the late Lady Osier was
in connection with some proof sheets of Professor
Harvey Cushing’s Life of her husband which she had
submitted to him:

St. Radegunds, Cambridge,

October 3, ’24.

Dear Lady Osler, — I am very sorry; but I have had an
awful week\ Incessant engagements until this evening and
I am now pretty tired. And M.B. Examinations are all the
time and fill up every cranny. I did finish the “reading” in
24 hours, but as I found a few points needing revision I felt
I could not just return the MS. without a letter. Then, as

288

SIR CLIFFORD ALLBUTT

1924 I saw Sir A. Garrod in London on Thursday, and as he said
he also found paragraphs which ought to be revised, I felt
the return of proof was not urgent. He may be sending you
his criticism. I have just explained to Prof. Dreyer (who is
here examining) that the remark on p. 283 that Sir William
was “dropped by the Cambridge Examining Board” cannot
be allowed to stand for one moment. It is not unlikely that
the legend arose out of one of Sir William’s jokes. He served
for a fair while, and then found — as Sir Archibald likewise —
that the dates of Oxford and Cambridge Medical Examina¬
tions are apt to clash! and he was otherwise very busy. He
resigned, before the ordinary time was out — for those
reasons — much to our regret.

He was an invaluable Examiner— sympathetic, broad¬
minded, acceptable to the men — and his “over-indulgence”
(if any) was in words and fun. He knew his duty and did it,
even if unwillingly in a few cases, as with all of us. “Can’t
we let the poor devil through?” he would say now and then,
but never pressed it against the general vote, in which
indeed he always agreed. I never remember his moving
the approval of a candidate against the reports of his col¬
leagues. As to his fun, we think the “pranks” are a little
overdone; true and characteristic, but they may readily
loom up against all the higher and more accomplished things,
apt to get out of proportion.

Excuse this very hurried scrawl to catch the last post
before the Sunday interval. Give our best regards to Mrs.
Chapin; I have an impression we owe her an answer to a
very welcome epistle. It was such a joy to see you! Council¬
man is here and lunches with us on Sunday; a great
pleasure.

He was invited by the Royal Society of Medicine
to give the annual Lloyd Roberts Lecture in 1925.
To this lectureship, founded, like others, by the will
of the late Dr. David Lloyd Roberts (1835-1920) of
Manchester, the Royal College of Physicians of Lon¬
don, the Medical Society of London, and the Royal

SIR CLIFFORD ALLBUTT

280

Society of Medicine, this being the order of their 1924
seniority in age, appoint in successive years. The
first lecture was given in 1923 by the late Sir Edmund
Gosse, and the second by Dr. Herbert R. Spencer in
1924. As the following letter to the President, Sir St.

Clair Thomson, shows, he accepted with some fore¬
bodings as to the future; these unfortunately were
justified, and Sir Arthur Keith1 gave the lecture on
“The Nature of Man’s Structural Imperfections” on
November 16, 1925.

St. Radegunds, Cambridge,

Dec. 21, ’24.

Dear St. Clair Thomson, — I hesitated in my answer to
Sir John MacAlister, and I hesitate again in reply to your
most kind invitation. How dare I at my age, give such
hostages to 1925! Marvellous to say I am very well, and un¬
less I deceive myself — have all my faculties (cerebral) intact
— quantum valeant. But my fear is lest, on failure past the
mid-year, I might leave a very short time to another orator
to prepare his address. MacAlister says you will take the
risk. And if I find myself running down I will try to give
you good notice. Or indeed my address might be read for
me by an understudy if I became physically incompetent to
read it. On account of shortening days, I should like the date
to be the earliest in the autumn convenient to the Society.

I believe the subject should be one of Medical History,
if so, I feel — speaking off-hand — disposed to write on the
(mainly clinical) story of Heart Disease from say Harvey to
Laennec — speaking roughly as to dates — pre-stethoscopic
period. But I may find this has been done — or twice done —
in the Harveian Orations? So before setting to I should have
to run up to the Royal College of Physicians and consult the
Harveian series before deciding. Perhaps the fixing of my
subject might wait?

My wife joins me in very kind remembrances and good
wishes for Xmas and New Year, and I — as a Midhurst
1 Brit. Med. Journ., 1925, ii. 929-32.

U

290

SIR CLIFFORD ALLBUTT

1924 colleague — am deeply impressed by your book — as devoted
as skilful and instructive — on laryngeal tuberculosis in that
Institution. — Yours very sincerely,

Clifford Allbutt.

As he always did, he had begun collecting material
for this lecture in the manner described in his Notes
on the Composition of Scientific Papers ( vide p. 162).

Together with James Mackenzie he contributed
to a symposium on the real value of strophanthus as
a cardiac remedy.1 On December 6 he defended2 the
use of the word “scientist” as quite as normal as
“artist” or “economist”; it had met with some criti¬
cism in the pages of Nature, among others from Sir
E. Ray Lankester, who expressed the hope that it
would not be used in the journal. In the December
number of the Classical Review he reviewed the
second volume of Dr. W. H. S. Jones’ English trans¬
lation of Hippocrates in Loeb’s “Classical Library”,
and, as in his previous notice of the first volume, de¬
scribed the scholarship, including strict textual re¬
vision of the work, as first-rate, and the translation as
“nervous, idiomatic, felicitous, and close to the
original”. At the same time he noticed, though at less
length, Dr. R. O. Moon’s FitzPatrick Lectures, 1921-
1922, at the Royal College of Physicians of London,
Hippocrates and his Successors in Relation to the
Philosophy of their Time.

The Papworth Annual, published at Christmas
1924, contained his last message to the institution
for which he had done so much:

My dear Friends, — Although but few of you are known
to me personally, yet I venture to write to you all as friends,

1 Therap. Claz., Detroit, 1924, N.S., xl. 153-01.

2 Nature, London, 1924, cxiv. 823.

SIR CLIFFORD ALLBUTT

291

because we are all engaged in a great plan for the relief of 1924
mankind from one of its direst plagues. This purpose which
animates us all is itself a bond of friendship. Can I use this
occasion and this season better than to impress this great
purpose of ours upon you, so that each one, however humble
his service in our community may be, or however crippling
his malady, may still play a willing part and bear his suffer¬
ings in the spirit of a member of a large company of us who
are working for this noble end. If so, if every one of us is
working together with his fellows for this purpose, or even
if for a time he may be only waiting in hope, then there are
no distinctions between us; no great folk and no lesser folk,
but all alike doing equally honourable work — for the motive
is the merit — all bearing each other’s burdens, all devoted
to this special service of mankind.

Your living together in one social body makes for a
common sentiment, a common hope, a common pride in
work which you have done, which you are doing, and which
you will do. When we work in companies we find our own
enthusiasms and our personal energies multiplied tenfold;
we are no longer just so many individuals, but an army
with its great heart and its high resolve.

Yet although above all we need these enthusiasms and
these energies, we must give them form and aim by a sound
judgment and by mapping out the most excellent way. We
want the gale, but also we want the helm and the helmsman.
Happily you are well led, and our enemy is in sight.

All this fighting spirit is, I am sure, within you; no
shirking, no murmurings, no turning tail; and let me remind
you that the eye of the nation is upon you.

Papworth is said to be an experiment; it was an experi¬
ment, no doubt, and no doubt from year to year it will be
developed and be renewed, but we contend that we have
passed beyond the experimental stage into that of a stead¬
fast success. There are a few other societies with the same
purpose, but on various plans and methods, none identical
with Papworth. From these we may be continually learning
something; but we want Papworth to win the race; to show

292

SIR CLIFFORD ALLBUTT

1924 itself the champion anti-tuberculosis association. We think
it takes the first place now, and we are determined it shall
always be in the vanguard. We are in an honourable com¬
petition, and we shall win if everyone, from the least to the
chiefest, will live by Queen Mary’s motto — “Be cheerful,
do your best, and make the best of everything”; then Pap-
worth will hold the field.

1925

“The Times” of January 6 contained a letter from
him on vitamins in bread, in which, as a member of
the Royal Society (War) Committee, he supported
the chairman— the late Professor Noel Paton — in his
advocacy of a larger percentage of milling in bread.
The last of his letters, published during his lifetime,
appeared in the same paper on February 14 in con¬
nection with the proposed alteration, artistically for
the worse, of the bridge over the Rotha’s “living
wave” close to Grasmere churchyard; it pleaded for
the preservation of the beauties of Lakeland scenery.
In the number of the Lancet containing his obituary
there was a letter,1 dated February 17, from him on
alkalis in certain diseases of the skin in connection
with some recent correspondence in its pages. A re¬
view,2 which he had passed for press, of Dr. W. H. S.
Jones’ The Doctor's Oath: The Early Forms of the
Hippocratic Oath, also appeared in the Classical
Review after his death.

Active to the last, he was busy during the last
months of his life with a book of a hundred pages, the
expansion of a post-graduate lecture at Cambridge,
Arteriosclerosis: A Summary View , which he was

1 Lancet, 1925, i. 4G4.

2 Classical Rev., London, 1925, xxxix. 139.

SIR CLIFFORD ALLBUTT

293

most anxious to finish, as lie now recognized that the 1925
sands of his life were running out, and accordingly
had decided to retire in July 1925, when he would
have entered his ninetieth year. This work, brought
out by Macmillan & Co., was actually finished and
contained references to papers published within a
few weeks of his death, but he did not live to see the
proofs. In the preface he wrote: “Since the publica¬
tion of my larger work ( Diseases of Arteries including
Angina Pectoris, 1915) I have collected more cases,
with necropsies, reinforcing and illustrating the dis¬
tinction between hyperpiesia and chronic renal dis¬
ease; but as such proofs now abound, and this survey
must be brief, I have given results only, postponing
the case reports for some other opportunity”. With
regard to periodic blood-pressure estimations of every¬
one at five-yearly intervals, which he was one of the
first to suggest in 1905 and now have become popular
in America as a prophylactic measure, he said: “This
rule would indeed set up an epidemic of fidgets”. He
deprecated the injunction to abstain from treating
high blood-pressure because it is a symptom only and
not the disease, and because it is compensatory, a
view which he obviously thought unsatisfactory, and
said: “Until we find the key to the metabolic lock,
why not treat a symptom, if the symptom itself be a
nuisance?” As an immediate method of treatment for
high blood-pressure he spoke highly of diathermy.

Except for the affliction of deafness, borne with
exemplary patience, Allbutt never grew old, his
vigorous physical health corresponding with his long
record of wonderful mental activity. Though he had
several accidents when bicycling about Cambridge,
he had escaped severe illness and, except during

294

SIR CLIFFORD ALLBUTT

1925 three attacks of tonsillitis before he was thirty, and
an influenzal illness in the spring of 1924, had never
spent a day in bed; this immunity was no doubt due
to careful personal hygiene, which included mountain
climbing and walking. On several occasions he de¬
scribed his method of protection against colds and
other infections by washing the mouth, throat, and
nasal passages with a mild antiseptic, and had been
known to say that after the age of forty-five every¬
one would be better without their natural teeth. A
curious symptom, however, for which he never con¬
sulted a medical man, first occurred fourteen years
before his death, when he suddenly woke up and
found that his breathing had stopped, though he
could continue to do so by definite voluntary effort;
naturally enough he at first thought that this was
cardiac and that his last hour had come. But after
this it recurred about once a year, and he noticed
that in a mild degree this symptom might come on
when he was deeply interested in reading. He wras the
subject, especially in his later years, of various
dietetic and drug idiosyncrasies of which he not un¬
commonly spoke. Some of these may perhaps be
traced to a gouty inheritance largely kept in check
by abstemious habits; at any rate, port always gave
him cramp, and bouillon in the evening was followed
by a sleepless night; if he drank tea during the day
he invariably woke up at 4 a.m. with a pulse rate
suddenly raised to 160, a reaction which lasted for
twenty minutes, and then went off as suddenly.
Coffee on the other hand slowed his pulse, normally
only 48, and accordingly he contented himself with
milk and water in the place of tea and coffee. By
taking five grains of thyroid extract he could bring

SIR CLIFFORD ALLBUTT

295

on the symptoms of Graves’ disease with great ner- 1925
vousness and tremor. He indeed thought that his
thyroid gland and vagus were more dominant than
in the average man. Other drugs, such as salicylates,
acted powerfully upon him, and he had to be careful
to take small doses only. His idiosyncrasy to tobacco
smoke, mentioned above (p. 282), was an additional
drawback to the public dinners which, however, he
cheerfully attended. A moderate but not fastidious
eater, he took most foods as they came, but sparingly
of meat; wine he seldom touched, although, as a
member of the Leeds Conversational Club (vide p. 29),
he was an authority on vintage clarets, a faculty
which he described, with a smile, at dinner a few days
before his death, as always expected in a successful
Yorkshire practitioner.

On February 21 he was fairly well, and worked
until eleven at night, when he went to bed, but awoke
with urgent breathlessness, and ten minutes later, at
1 a.m. on Sunday morning, he died before his medical
adviser arrived, and, as he would have wished, in the
full tide of his activities.

The funeral service, on February 25, was held in
the chapel of Gonville and Caius College, where
William Harvey worshipped and John Caius lies
buried under the simple inscription: “Fui Caius”; at
the same time there was a memorial service in Great
St. Mary’s Church. He was then borne through the
Gate of Honour, Senate House Passage, and King’s
Parade to Trumpington Churchyard.

The gross value of his estate was £56,963, and
the net personalty £50,137. To the Fitzwilliam
Museum he left his portrait by Sir William Orpen,
R.A., and, on the death of his wife, a quantity of

296

SIR CLIFFORD ALLBUTT

1925 antique furniture and drawings and paintings by
noted artists, including Landseer, Crome, Romney,
Rossetti, G. F. Watts, J. M. W. Turner, and Fripp.
To Gonville and Caius College three silver and gilt
drinking horns or cups (known as Swedish cups),
requesting that his name as donor should be en¬
graved thereon. Subject to the fulfilment of personal
bequests and life interests and the failure of issue,
the ultimate residue of his property was left to
Gonville and Caius College to found Clifford Allbutt
Fellowships for medical research, or otherwise for
the benefit of the College in the discretion of the
Master and Fellows, provided that no part thereof
be used for building.

During his eighty-nine years there had been
changes which it is difficult to imagine will ever be
rivalled in the history of medicine. Born before the
introduction of anaesthesia, he had seen the birth
and development of bacteriology and immunology
and of antiseptic and aseptic surgery, the creation
of the nursing profession, the astonishing progress
of public health and preventive medicine, the
scientific study of tropical medicine, the discovery
of X-rays and radium and of vitamins and their
application to medical practice, the development
of neurology, cardiology, bio-chemistry, endocrino¬
logy, and specialism, and many other advances.
In the course of nearly sixty-five years of active
professional life he made many additions to the
science and art of medicine. Some of these are now
so incorporated in common knowledge and practice

SIR CLIFFORD ALLBUTT

297

that our indebtedness in this respect is largely for¬
gotten, such as the invention of the form of clinical
thermometer now in use, the description of syphilitic
disease of the cerebral arteries, and the separation
of hyperpiesia or the condition of high-blood pressure
of obscure origin from that of kidney disease. As
has been shown in this record of his activities, his
contributions covered a very wide field; but the
circulatory system received his special attention:
for example, the stimulus he gave to the study of
arterial blood-pressure, his share in establishing the
routine use of the sphygmomanometer in medical
practice, and his view of the relation between high
blood-pressure and arterial disease; his advocacy
of the aortic origin of angina pectoris; and the in¬
fluence of strain and overwork on the heart and
arteries. These subjects he continuously elaborated
in the light of his fresh observations, and correlated
with the work of others, on which he kept an ever-
watchful eye. Though it may still be too soon to
form a mature opinion, it would seem probable that
his claim to fame will be even greater when, with
the passage of years, his work is seen in proper
perspective.

He was a scholar in the broadest sense, a pro¬
found medical historian, and a persistent advocate
of the need for a sound general education as a basis
of medical training. In Lieut. -Colonel F. IT. Gar¬
rison’s words,1 “few approached him in literary
style and the power to stimulate thought”. But he
was far more than a scholar or a learned man, for
his combination of versatility, wisdom, true religion,
and humanity was of a kind extremely rare, if not

1 Garrison, F.. History of Medicine, p. G80, 4lh edition, 1929.

298

SIR CLIFFORD ALLBUTT

dying out, in a world that has witnessed many
changes in a comparatively short time.

In early life an original investigator both in the
laboratory and the wards, then a busy consulting
physician, and after that for thirty-two years a
Regius Professor with a world-wide reputation, he
was throughout an independent thinker, a cultivated
man of letters, and a philosopher; but greater even
than these were the character and personal influence
of the man who became the undisputed doyen of his
profession in this country.

Always young in mind, he was in sympathy with
all sorts and conditions of men in many lands, and,
though wisely critical and not carried away by them,
with new ideas. Ever alert to welcome the germ of
a real advance and generous in encouraging unknown
writers, he took the keenest interest in new projects
for the advancement of science in connection with
medicine, and indeed with everything that was
wholesome and true. With a mind that ran on large
lines, he saw a subject in all its aspects, so that
though, when the problem presented was already
familiar, he would express his opinion at once and
agree, perhaps with some reservation, or quite
frankly dissent, at other times he would postpone
judgement until he could consider it at leisure. Thus
he avoided the mistake of supporting a fallacious
though at first sight promising departure or move¬
ment. Essentially a humanist, he was a modern
scholar-physician, and, while feeling the pulse of
advancing science and reading omnivorously in
French, German, and English, never let his know¬
ledge of Latin and Greek get rusty. A lover of the
contents rather than of the editions of books, he

SIR CLIFFORD ALLBUTT 299

had with discrimination collected a library ranging
widely over the intellectual as well as the profes¬
sional aspects of knowledge. As has been suggested
in earlier parts of this record, he was essentially
artistic, a lover of music and the arts, extremely
critical in his use of the written word, and a judici¬
ous, discriminating, and persuasive speaker, with
an excellent delivery of matter ever fresh and
interesting.

With hair that turned white somewhat early and
a fresh complexion, with his well-groomed appear¬
ance and urbanity, he would have been taken by a
stranger for a distinguished man of the world rather
than for the scholarly professor. Aristocratic in
appearance and courtly in manner he was the most
approachable of men, modest almost to a fault as
regards his own attainments, enthusiastic in praise
of his colleagues and juniors, and so tolerant that
he seemed never to notice any small shortcomings.
With the delightful equanimity and serenity that
made for happiness in his fellows, and an eager wel¬
come from those privileged to be his companions in
work or pleasure, there was nothing of the laudator
temporis acti spirit or of the attitude of superiority
which sometimes marks those in a senior position.
In his long and varied life he acted up to the dictum
that “only two things are essential — to live up¬
rightly and to be wisely industrious”. With a genius
for friendship and much given to hospitality, he was
wonderfully seconded by his wife during their fifty-
six years of married life, as many generations of
Leeds students and Cambridge undergraduates
gratefully remember.

INDEX

Abbott, Maude E., 240
Abney, W. de W., 51
Ackworth, enteric fever at, 43
Acland, Sir Henry W., 41, 108,
109, 145, 250

Adami, J. G., 118, 138, 233, 234
Adams-Stokes syndrome, 254
Addenbrooke’s Hospital, 111, 133
Aitkin, Sir William, 35
Albuminuria and pregnancy, 132
Alenin, 8

Allbutt, Edward, 5
Allbutt, George, 1, 21
Allbutt, John, 1
Allbutt, Lady, 5, 43
Allbutt, Mrs. Marianne, 2
Allbutt, Miss Marianne, 5
Allbutt, Sarah Isabella, 5
Allbutt, Rev. Thomas, 1. 39
Allbutt, Sir T. Clifford, birth, 1
early years, 1-19
schooldays, 7

enters Gonville and Caius
College, 9

his artistic temperament, 11
medical education, 12
post-graduate study, 14
consulting physician at Leeds,
20

medical appointments at Leeds
21

medical school appointments,
27

waiting period, 28, 31
his clinical thermometer, 36
his love of music and organs,
37, 82

elected F.S.A., 39
marriage, 43

his love of mountain-climbing,
50, 234, 281

Allbutt, Sir T. Clifford (contd.)—
as prototype of Lydgate in
George Eliot’s Middlemarch,
59-61

character as a consultant, 65
M.R.C.P., 74

Goulstonian Lecturer, 74, 84,
86

elected F.R.S., 80
removal to Carr Manor, 81
elected F.R.C.P., 84
retires from staff of Leeds
Infirmary, 88
as a clinical teacher, 89
visit to Switzerland, 37, 94
Commissioner in Lunacy, 95
moves to London, 95
professional income at Leeds,
98

and the “Sunday tramps”, 100
appointed Regius Professor,
108

elected Fellow of Caius, 109
Physician to Addenbrooke’s,

111, 133

moves to Cambridge, 114
his System of Medicine, 117, 120
System of Gynaecology, 120
visit to Greece, 125
visit to Italy, 129, 142
views on women doctors, 130
visit to Moscow, 136
visit to America, 137-139, 165,
167

Lane Lecturer, 137
visit to Japan, 137
visit to Canada, 138, 177
Hon. M.D., Dublin, 140
Hon. D.Sc., Manchester, 140
Examiner, R.C.P., 141
Harveian Orator, R.C.P., 145

301

302

SIR CLIFFORD ALLBUTT

Allbutt, Sir T. Clifford (contd.) —
Robert Boyle Lecturer, 149
Cavendish Lecturer, 155
Cons. Phys., Belgrave Hosp.

for Children, 157
his Notes on Composition of
Scientific Papers, 159
his literary composition and
style, 160-163, 203
his use of medical terms, 161,
203

delegate to St. Louis Exhibi¬
tion, 165

visit to Paris, 171
elected D.Sc., Leeds, 177
knighthood, 182
dinner in his honour, 185
Censor, R.C.P., 185, 224
representative on General Medi¬
cal Council, 186
anticipates aMinistry of Health,
187

his portraits, 188, 251
FitzPatrick Lecturer, R.C.P.,
191, 194, 197

elected LL.D., St. Andrews, 201
interest in National Insurance
Act, 201, 206, 217
Finlayson Lecturer, 207
member of Medical Research
Council, 208
D.Sc., Durham, 210
Linacre Lecturer, 212
war duties, 214, 221
views on professional fees, 219
views on compulsory Greek,
223

as a lay preacher, 226, 242, 249,
252 “

as a staunch Churchman, 227
his spiritual life, 227-229
interest in theological ques¬
tions, 228

President of Papworth Village
Settlement, 231
President, British Medical As¬
sociation, 236, 265
Hon. Fellow of Royal Society
of Medicine, 243
Privy Councillor, 251
Moxon Medallist, 259
B.M.A. gold medallist, 264
President, West London Post¬
graduate College, 268

Allbutt, Sir T. Clifford (contd.) —
West London Medico-Chirurgi-
cal Society medallist, 272
his tributes to Osier, 241, 274,
287

his love of the English Lakes,
234, 281

signs of impaired health, 287,
289, 294

last days, 293, 294
idiosyncrasies, 294
death, 295
his estate, 295

advances in medicine during
his lifetime, 297
his literary style, 160, 297
personal characteristics, 294,
298

Allbutt Library, 251
Aimer, Christian, 50
Alpine climbing, 50, 51, 62, 63,
85, 174. See also Mountain¬
climbing
Amber, 122

American Academy of Arts and
Sciences, 263
Anderogg, Melchior, 50
Anderson, Sir Hugh, 251, 254
Andrew, James, 75
Angina pectoris, 125, 126, 137,215
cause, 191, 263, 271, 285
earliest account of, 284
early experience of, 13
nature of, 193
origin of, 126
pathogeny of, 136
surgical relief of, 258, 284
treatment of, 188, 271
Animal pathology, 93, 94. See
also Pathology, comparative
Annotation of books, 29
Aortic disease, 155, 156
Aortic origin of angina pectoris
and hyperpiesia, 126
Aortic regurgitation, 77
Aortitis, 156
Apoplexy, 155, 170
Appendicitis, 195, 196
Appendix dyspepsia, 195, 196
Aran, F. A., 48
Argyll Robertson pupil, 127
Army Medical Service, 149
Arterial pressure, causes of rise of,
154. Sec also Hyperpiesia

SIR CLIFFORD ALLBUTT

303

Arteries, diseases of, 1.37, 214-
Art eriosclerosis, 127, 153
and renal disease, 199
and smoking, 283
blood-pressure in, 153, 271.

See also Hyperpiesia
causes, 183

classification of, 153, 178
his book on, 215
last work on, 293
nature of, 178
treatment, 271

Association of American Phy¬
sicians, 248

Association of Physicians of
Great Britain and Ireland,
211

Asthma, cardiac, 151, 200
Athenaeum, The, 100
Athens, visit to, 125
Athletics, 193
Avebury, Lord, 172

Babbage, Charles, 56
Bacon, Francis, 24, 207
Bacon, Roger, 146, 149, 150
Bagot, Sir Charles S., 97
Bailey, James Blake, 92
Baines, Sir Edward, 46
Balfour, Lord, 285
Banks, Sir John T., 43
Barclay, A. E., 236
Barlow, Sir Thomas, 122, 178,
181, 224

Barr, Sir James, 286
Barrs, A. G., 89
Bastian, H. Charlton, 43, 61
Bastianelli, 143
Bazire, P. V., 14
Beaunis, 103
Beck, E. A., 169
Belgrave Hospital for Children,
157

Bell-ringing, 6, 270
Bennett, Sir James Risdon, 74
Bernard, Claude, 179
Bernheim, H., 103
Besley, E. S., 60
Betlmne-Baker, J. F., 228
Bewick’s engravings, 23
Bignami, A., 143
Billings, J. S., 139, 167
Bio-chemistry, 236
Birch-Hirschfeld, 140

Bird, Golding, 13
Blandford, G. F., 126
Bland-Sutton, Sir John, 253, 254
Blood, viscosity of, 199
Blood pressure, 170, 184
and arteriosclerosis, 153
importance in clinical medi¬
cine, 173

in later life, 153, 154
periodic estimations of, 293
Sec also Hyperpiesia
Blood tension, 134
Bodington, George, 70
Bond, H. J. Hales, 105, 106
Bonney, Thomas George, 50, 283
Bousfield, C. E., 30
Bowlby, Sir Anthony, 195
Bradbury, J. B., 131, 164
Brady, William, 225
Brain, “choked disc” in disease
of, 57, 59

syphilitic disease of, 40, 58
“Brain-forcing” in schools, 73, 86
Bramwell, J. Milne, 103
Braybrooke, Lord, 158
Bread, vitamins in, 292
Brehmer, H., 70
Bridges, J. H., 60
Bridges, Robert, 101
Bright’s disease, 68, 205
British Medical Association, gold
medal, 264

President, 66, 236, 250, 265
Broadbent, Sir Wm., 43, 54, 68,
109, 114, 140, 152, 154, 171,
182

Brock, J. A., 226
Bronte family, 2, 3, 4
Brown, Sir Charles, 177, 181, 268
Browne, Edward G., 258
Browne, Sir Thomas, 172
Browning, Oscar, 62
Brunton, Sir Lauder, 57, 141,
142, 165, 193, 218
Burdon-Sanderson, Sir John, 118,
164, 165, 174, 239
Bury, Judson, 144
Butier, Rev. H. M., 139
Butlin, Sir Henry, 196
Buzzard, Thomas, 16
“Byzantine Medicine”, 191, 207

Caian Scholarship, 9
Caius, John, 251

SIR CLIFFORD ALLBUTT

304

Cambridge, Addcnbrooke's Hos- I
pital and the Regius Pro¬
fessors, 111, 133
arms of the Regius Professor
of Physic, 107

degrees for women at, 129, 259
Diploma in Medical Radiology
and Electrology, 235, 253
examinations in pharmacology,
131

Gonville and Caius College, 9
Gonville and Caius Fellowship,
109

Greek at, 168, 223
Licence to practice physic, 12
Natural Sciences Tripos, 150
Regius Professor of Physic at,
97, 105, 111
stipend, 107

Regius Professors at, 105, 107
Regius Professorship, custom
and procedure, 109, 110, 111
smallpox outbreak (1903), 21
superannuation of Professors,
257

Surgery Professorship at, 133
“The Apostles”, 29
Tropical Medicine and Hygiene
Diploma, 155
University library, 169
women students at, 130, 131
Cambridge Appointments As¬
sociation, 142

Cambridge Conversation Society,
29

Cambridge Hospital for Special
Diseases, 181

Cambridge Institute of Compara¬
tive Pathology, 243
Cambridge Medical School, 131,
135, 211

and Addenbrooke’s Hospital,
111, 133

need for new building, 131, 143
opening of the new building,
164

rebuilding of, 136
Cambridge Medical Society, 128
Cambridge University Associa¬
tion, 139

Campbell, Colin, 151
Campbell, Harry, 154
Camphor, homoeopathic, 63
Canada, visit to, 178

Canterbury, King’s School, 7
Cardiac asthma and dyspnoea,
151, 200

Cardiac delirium, 283
Cardiac pathology, 204
Cardio-arterial disease, 127. See
also Heart

Carr Manor, Meanwood, 81
Caton, Richard, 148
Celli, A., 143
Celsius’ thermometer, 36
Cerebral arteries, syphilis of, 40.

See also Nervous System.
Cervical glands, enlarged, 89, 90,
122

Chadwick, Charles, 5, 21, 24, 28,
43, 65, 98, 124
Chadwick, C. M., 65

on Allbutt as a consultant,
65

Chadwick, William, 5
Champouillon, 48
Charcot, J. M., 103

death and appreciation of, 122,
123

Charcot’s tabetic hydrarthrosis,
42

Cheadle, W. B., 10
Chest, exploration of, 59
Cheyne, Sir Wm. Watson, 181
Chlorosis, 147
“Choked disc”, 57, 59
Christian, Henry, 245
Christison, Sir Robert, 67
Church, Sir Wm., 145, 180
Churchill, Winston, 148
Clark, Sir Andrew, 108
Clark, J. Willis, 169
Clark, E. Ivitson, 30
Clarke, Jacob A. Lockhart, 12,
14, 18, 41, 43, 53
Classical education, 113, 168,
169

Classical Review, contributions
to, 128, 136, 153, 164, 187,
198, 209, 222, 225, 232, 256,
275, 290, 292
Classical scholarship, 276
Classics versus Science, 217
Clifford, Edward, 5
Clifton Asylum, 40
Clinical units. 235, 242, 260
Colchester Military Hospital, 221
Cold baths, 55

Collier, William, 164, 190
Comparative pathology. See
Pathology

Composition of scientific naners
159-163, 269 P ’

Comte, Auguste, 12, 60
Congreve, Richard, 60
Conjoint Examining Board, phar-
macology examinations, 131
Consultations, need for, 101
Consulting work, 27, 65, 89, 96,

Consumption. See Tuberculosis
Contract practice, 202, 280
Conway, Sir Martin, 50
Cooke, Arthur, 12
Cooper Medical College, San
Francisco, 137
Cormack, Sir John Rose, 14
Corrigan, Sir Dominic, 125
Crane, John, 107
Crawford and Balcarres, Earl of,

Crawfurd, Raymond, 201
Creighton, Charles, 101
Crichton-Browne, Sir James, 41
57, 83, 96, 251
letters to, 148, 183
Criminal responsibility of the in¬
sane, 126

Cronin, C. W., 141
Cronin, Rev. H. S., 64, 141, 267
Crookes, Sir Wm., 170
Crookshank, F. G., ns 272

rmiSby’wr Thomas> 204, 205
Cullen, Wm., 144

Cummins, Lyle, 253
Cunningham, C. D., 50
Curne, James, 35, 55
Curtis, J. G., 216
Cushing, Harvey, 241
letters to, 249, 274, 287
Cushny, A. R., 193
Cyanotic delirium”, 90 91
Cyclists’ Touring Club, 52

Daily, J. F. Halls, 269
Darwin, Charles, 227
Darwinian Theory, 1 56
Davies, Emily, 130
Davos treatment, 70 71
Davy, John, 35 ’

Degrees, for women, 129 130
honorary, 140, 177, 201, 210

SIR CLIFFORD ALLBUTT

305

Delirium, cardiac, 286

"cyanotic” or “travelling”, 90,
9 1

Dent, Clinton, 50, 101, 157
Devonshire, Duke of, 139
Devouassoud, Francois, 50, 51
Dewsbury, early recollections of,
5, 6

Dickinson, W. H., 9, 10, 12, 42
53, 73 ’ ’

Diet, 63, 167, 294
Disease, causes of, 68, 69
classification of, 38, 93, 118
definition of, 179
electrical treatment, 53
general observations on, 170
investigation of special dis¬
eases, 180, 181
names applied to, 178
nature of, 36, 47, 54, 170, 175,
179, 244

nomenclature of diseases, 203
open-air treatment, 32-34 41
48, 49
treatment of, 47, 54
use of the term, 203
vicious circles in, 198
Dispensaries for tuberculosis, 261,

Dixon, W. E., 170, 186, 194
Dobie, William, 148
Dreschfield, Julius, 84, 151
Dublin Honorary Degree, 140
Duchenne, G. B. A., 14-16, 18, 41
Duckworth, Sir Dyce, 194
Dufferin and Ava, Marquis of, 20
du Val’s thermometer, 34, 36
Dying declarations, 42
Dyspepsia, 44, 195, 196
Dyspnoea, 151, 200
morphine in, 44

Eddison, J. E., 23, 24, 78, 187

Eden, T. W., 121

Edinburgh R°yal Medical Society,

Education, “brain-forcino” dur¬
ing, 73

classical, 113, 168, 169
function of science in, 189 217
218 ’ ’

modern, and health, 73, 86
secondary, 205, 218
observations on, 101, 172

X

306

SIR CLIFFORD ALLBUTT

Education ( contd .) —

university, function of, 113
See also Medical education
Edward VII., 164
Einstein, 228
Electrotherapy, 53, 64
Eliot, George, 4, 30, 55

supposed delineation of All¬
butt by, 59-61
Empyema, 26

Encyclopaedia of Medicine, 210
Endocarditis, malignant, 75
England, Margaret, 64, 125, 129,
141

English composition, 160-163,
273

Enteric fever, propagation of, 43
Eugenics, 115, 152, 156
Ewald, C. A., 196, 214

“Facts” and “theories”, 160, 203
Fahrenheit’s thermometer, 34
Faith-healing, 196
Farr, William, 38
Fees, professional, 219, 220
Fell and Rock Climbing Club, 51
Ferrier, Sir David, 57, 166
Fever hospitals, early, 21
Fevers, 22

and infectious diseases, 114
early experience of, 21
free ventilation in treatment,
32, 34, 41, 42, 49
Fildes, Sir Luke, 100
Finlayson Lecture, 207
FitzPatrick Lectures, R.C.P., 191 ,
194. 197, 234
Fletcher, Sir Walter, 208
Florio, Commendatore, 142
Foster, Sir Michael. 105. 109, 129,
130, 131, 158
Fothergill, J. Milner, 57
Fowler, Sir J. Kingston, 142, 147,
261

Fox, Wilson, 55. 174
Frere, W. H., 97
Fresh-air treatment, 32, 34, 41,
49 70 1 42
Freshficld, D. W., 50
Freyer, Sir Peter, 259
Fuller, II. W., 12

Gairdner, Sir W. T., 16, 18, 43,
93, 102, 103, 206

Galitzin, Prince, 136
Garrison, Lt.-Col. F. H., 17, 38,
76, 226, 256

letters to, 18, 191, 268, 274,
286

Gaskell’s Life of Charlotte Bronte,
2, 3

Gastric lavage, 43
Gauvain, Sir Henry, 273
Gee, Samuel, 120
General Medical Council, 52, 186,
187

General paralysis and svphilis,
98, 99

Gesner, Conrad, 277, 278
Gibson, Geo. Alexander, 142, 176,
199, 206
Giddiness, 64

Glisson, Francis, 10€, 225, 251
Glover, T. R., letter to, 276
Goodhart, Sir James, 69, 87
Gosse, Sir Edmund, 3, 4, 289
Gott, Bishop John, 24, 173
Goulstonian Lectureship, R.C.P.,
74, 75, 84, 86
Gout, 246, 247

Gowers, Sir William, 58, 166, 179
Grassi, 143
Graves’ Disease, 92
Gray, Alan, letter to, 36, 37
Greek at Cambridge, 168, 223
Greek medicine, 191, 194, 197,
212, 232, 256, 275, 280
Greek Medicine in Rome, 191,
194, 197, 232, 256
Green, Christopher, 106
Griffith, T. Wardrop, 20, 52
letter to, 116
Gull, Sir Wm,, 83, 115
Gumprecht, 53
Gunn, Marcus, 58
Gynaecologists, 166
Gynaecology, 87, 88

A System of Gynaecology, 120,
121

Haldane, J. S., 147, 270
Hall, William, 279
Hallam, A. H., 29
IJallett, Sir Frederick G., 265
Halsbury, Lord, 97
Hardwick Clinical Prize, 24
Hardwick, R. G., 24
Hardy, Thomas, 103

SIR CLIFFORD ALLBUTT

307

Harrison, Frederic, 60
Hart, Ernest, 196
Harveian Oration, R.C.P., 20,
75, 145

Haslip, G. E., 287
Haughton, Samuel, 54
Haviland, John, 212
Heart disease, Adams-Stokes
syndrome, 254
among miners, 46
alcoholic dilatation, 149
arrhythmia of, 149
asthma of, 151, 200
delirium of, 90
“disordered action”, 222
mechanical strain causing, 45,
62, 137

modern aspects of, contro¬
versy with Sir James Mac¬
kenzie, 226
morphine in, 44, 48
pathology of, 204
Heart Hospital (Hampstead), 221
Heaton, John Deakin, 24, 46, 48
death and appreciation of, 78
Heberden, Wm., the elder, 212,
284

Heiberg, J. L., 209
Hellenic Society, 125
Hemiplegia, functional, in preg¬
nancy, 49

Henslowe, George, 11
Herringham, Sir Wilmot, 174,
188

Heubner, 40
Hey, Samuel, 24
Hey, William, 8, 24, 25, 81
Hey, Wm., secundus, 56
Hill, Alex, 108, 139
Hobday, F., 253, 265
Hobson, Richard, 27, 98
Hodgson’s disease, 156
Holidays, necessity for, 51, 52
Holmes, Timothy, 14
Holth, S., 256

Honorary degrees, 140, 177, 201,
210

Hope, James, 46
Hopkins, Sir Gowland, 187, 208,
246

Horder, Sir Thomas, 75
Horner, N. G., 269
Horsley, Sir Victor, 157, 166,
181

Hospital Medical Units, 235, 242,
260

Hospitals, 187

pavilion type of, 25
Hough, C. H., 281
Hughes, T. McKenny, 122
Humphry, Sir Geo. Murray, 12,
84, i05, 131, 133, 250
Hunkin, Archdeacon, 227
Hunt, Leigh, 1
Hunter, John, 24
Huntington’s chorea, 233
Hurry, J. B., 198
Hurst, A. F., 254
Hutchinson, Sir Jonathan, 180
Hutchison, Robert, 194
Huxley, Thomas Henry, 251
Hydrology, medical, 254
Hydrophobia, 58
Hyperpiesia, 55, 128, 134, 137,
154, 199, 215, 293
causes of, 154
origin of, 126

treatment, 55, 173, 174, 293
Hyperpyrexia, 72
Hypnotism and suggestion, 102,
103

Hypodermic medication, 44, 45

Ilkeston, Lord, 142
Income, professional, 98
Industrial disease, first systematic
account of, 25
Infantile paralysis, 53
Influenza, 171, 180, 280
Insanity, 99, 100

and neurasthenia, 152
and syphilis, 98, 99
hospitals for the insane, 104
in criminal cases, 126
investigation of cause and cure,
180

treatment of, 168, 179
Insurance Acts, 201, 202, 206,
217, 280

International Medical Congresses,
83, 136, 209

Iodides, in arterial diseases, 188
Isle of Wight, 7
Italy, visit to, 129
Iveagh, Lord, 213

Jackson, J. Hughlings, 13, 16, 18,
56, 57

x 2

308

SIR CLIFFORD ALLBUTT

Jameson, Rev. K., 226
Japan, visit to, 137
Jebb, Sir R. C., 139
Jenkinson, Francis J. H., 169
Jenner, Sir Wm,, 18, 19, 41, 72
opposition to women doctors,
75

Jessop, T. R., 26
Johnson, George, 73
Johnson, Samuel, 10
Jones, C. Handheld, 54
Jones, Henry Bence, 12, 13
Jones, W. H. S., 290
Juan, Johann, 63

Kanthack, A. A., 117, 118, 177
Keen, W. W., 243
Keith, Sir Arthur, 289
Kennedy, Thomas Stuart, 30, 37,
50, 82

Kerr, Norman, 102
Kidney disease and arterio¬
sclerosis, 199
dropsy of, 235
ophthalmoscope in, 56
Kidneys, granular, 68, 69, 72
King Edward VII. Sanatorium,
Midhurst, 71, 176
Kipling, Rudyard, 100
Knee-jerk, 127
Knighthood, 182
Koch, Robert, 147
Kussmaul, Adolf, 66, 77, 152

Laboratory investigation, 236,
237

Lane Lectures, 137, 215
Lang, W. H., 265
Lankester, Sir E. Ray, 234, 290
Latham, Arthur, 11
Latham, John, 11
Latham, Peter Mere, 11
Latham, Peter Wallwork, 10, 111
and Sir M. Foster, 158
Latin, as a language, 175
teaching of, 169
Law and medicine, 78, 174
Law Courts, medical witnesses in,
78-80

Leeds, considting practice at, 27,
28, 65, 89, 96, 98
early life at, 20

early practice and “waiting
period” at, 28

Leeds (contd.) —

eminent physicians at, 98
professional income at, 98
surgery at, 25, 26
“team-work” at, 27
Leeds and County Club, 30
Leeds Conversation Club, 29
Leeds Dispensary, 22
Leeds General Infirmary, 27, 188
early days of, 24, 25
physician to, 24
retirement from the staff, 88
Leeds House of Recovery, 18, 22
nurses and cases at, 21
physician to, 21
treatment of fevers in, 49
typhus feverat(1865-66), 32-34
Leeds Medical School, work and
lectures at, 27

Leeds Philosophical and Literary
Society, 23, 46, 76
Leeds and West Riding Medico-
Chirurgical Society, 83, 91
Legal cases, medical evidence in,
78-80

Leighton, Lord, 100
Levine, S. A., 221, 222
Lewes, George Henry, 14, 16, 18,
30, 61

Lewis, Sir Thomas, 204, 221
Liard, M., 171
Liebault, 103
Linacre Lecture, 212
Lister Institute, 213
Lister, Lord, 210
Literary composition and stvle,
161-163, 273, 297
Littlewood, IT., 258
Liverpool University, 157
Lloyd Roberts Lecture, 288
Lockwood, Lucy, 129
Lockwood, Sir Frank, 129
Lockyer, Sir Norman, 252
Locomotor ataxia, 41
Long, Lord, 58
Longevity, 42
Loomis, A. L., 72
Lorking, Thomas, 106
Lumleian Lectures, R.C.P., 226
Lunacy, Commissioner in, 95, 96,
97

Lunacy. See Insanity.

Lunatic asylums, 40
Lupton, Alan, 44

SIR CLIFFORD ALLBUTT

309

Lydgate, Tertius, Allbutt as the
prototype of, 59-62

MacAlister, Sir Donald, 101, 131,
181, 186

MacAlister, Sir J. Y. W., 92
MacCormack, Henry, 70
Macewen, Sir Win., 166, 243, 265
McFadyean, Sir John, 253
McGill, A. F., 259
Macllwaine, S. W., 204
Mackenzie, Sir James, 29, 68, 150,
176. 186, 200, 221, 226, 244,
246, 285

Mackenzie, Sir Stephen, 72
Makins, Sir George, 250
Malaria, 142, 143
Manchester Victoria University
honorary degree, 140
Manson, Sir Patrick, 142, 155,
243

Marriage, 43

Marsh, Howard, 133, 164, 181, 185
appreciation of, 213
Marshall, Horace, 20
Marshall, Thomas, 20, 146
Martime, George, 35
Matthews, C. E., 50
Maurice, F. D., 29
Mayo, Frank, 65
Mediastinal sarcoma, 67
Medical education, 110, 171, 172,
176, 232, 250, 266
in London, 171
observations on, 110, 187, 244
past and present, 266
“Medical etiquette”, 85
Medical evidence in legal cases,
78-80

Medical practice, apprenticeships
in, 101, 102

need for consultations in, 101
Medical profession and public
morality. 91
Medical reform, 52
Medical research, 208, 236, 237,
243, 244

Allbutt Fellowships, 296
controversy with Sir James
Mackenzie, 226
Universities and, 250
Medical Research Committee,
207, 208, 213, 220
Medical student, training of, 266

Medical terms, correct use of,
160, 178, 191, 273
Medical Units in Hospitals, 235,
242, 260

Medicine, A System of Medicine,
117-119
and law, 174
and music, 11, 268
and psychology, 99
and surgery, 83, 155

artificial distinction between,
32

historical relations, 166
relations of, 220
broad outlook in, 115
clinical, 233

Greek, 191, 194, 197, 212, 232,
275, 280

history of, 167, 274, 280, 286
in 1800, 144
integration of, 277
in the nineteenth century, 138
in the twelfth century, 236
modern, observations on, 232,
233

on the study of, 144, 145
post-graduate study, 145
progress and development of,
46, 47, 135, 296
specialism in, 166, 167, 266
teaching of, observations on,
112, 144, 145

theory and practice in, 135
Meniere syndrome, 17
Mental anxiety, as cause of
kidney disease, 68, 69
Mental hospitals, 104
Mercier, Charles A., 126, 219
Meredith, George, 101
Metchnikoff, 154
Metallotherapy, 72
Michell, R. W., 121, 217
Mickleburgh Scholarship, 9
Middlemarch, 59, 60
Miners, heart disease among, 46
Ministry of Health, 187
Mitchell, Weir, 120
Moon, R. O., 290
Moore, Sir Norman, 205, 212, 250
Morphine, 55, 278, 279
in cardiac disease, 45, 48
in dyspepsia, 44
in neuralgia, 44
in uraemic asthma, 71

310

SIR CLIFFORD ALLBUTT

Morris, Sir Henry, 180, 190
Morris, Sir Malcolm, 142
Mott, Sir Frederick YV., 118, 197
letter to, 99
Moulton, Lord, 208
Mount Vernon Hospital, 176
Mountain -climbing, 50, 51, 85,
234, 281

beneficial effects of, 174
effect on power of speech,
85

physical effects of, 56, 62, 63
Moxon Medal, 259
Moxon, W., 31

Moynihan, Lord, 14, 81, 153, 195,
225

letter to, 26
Muir, R., 265
Miinsterberg, 165
Music, love of, 36, 82, 124
medicine and, 11, 268
Musser, J. H., 152
Myers, A. B. R., 46
Myers, A. T., 101
Myotonia congenita, 157

National Insurance Act, 201, 202,
206, 217

National League for Physical
Education, 219
Neck, enlarged glands of, 122
scrofulous, 89, 90
Nervous diseases, and modern
life, 129

ophthalmoscope in, 57
Nervous system, syphilitic disease
of, 40, 42, 58, 64, 258
Neuralgia, morphine in, 44
Neurasthenia, and insanity, 152
Neuroses, 86, 87
Neurotomy for tetanus, 53
Neville-Grenville, Hon. George,
159

Newman, Sir George, 232, 235,
242, 245, 247, 253, 260
Nitrites, 188

in angina pectoris, 263
Nomenclature of disease, 203
Nosology, comparative, 93, 94
Notes on the Composition of
Scientific Papers, 159, 269
Nunneley, Thomas, 24, 80
Nursing and nurses, 21
Nut tall, C. II. F., 155

Oesophageal auscultation, 67
Ogle, John William, 12, 13, 28,
40, 56-58

Open-air treatment, 48
of fevers, 32-34, 41, 42, 49
of pulmonary tuberculosis, 70,
71

Ophthalmology, 41, 56, 57
Ophthalmoscope, 13, 39
use of, 56-58

Opium, in treatment of fevers, 34
Oppenheimer, B. S., 221
Optic neuritis, 40, 41
Organ-playing, 36, 37, 82
Orpen, Sir William, 251, 295
Osier, Featherston, 138
Osier, Lady, 248, 287
Osier, SirYVilliam, 61, 84, 86, 121,
138, 140, 156, 164. 177, 180.
185, 193, 196, 205, 211, 243,
249

and Allbutt, 74-76
appointment as Regius Pro¬
fessor, 109

appreciations of, 238-241, 245
as an examiner, 288
characteristics, 274
Cushing’s biography of, 288
death of, 245
Goulstonian Lecturer, 75
Membership and Fellowship of
R.C.P., 74

on the “fixed period”, 76, 156,
172

70th birthday celebration, 216,
237-240

Oxford, degrees for women at,
129, 130

Regius Professorship at, 105
women students at, 259
Oxford Medicine, The, 245, 246

Paget, Sir George, 10, 12, 30, 105,
129, 212

Paget, Sir James, 61 , 70, 83, 94, 250
“Paget’s Disease”, 70
Palermo, visit to, 142, 143
Palissy, Bernard, 23, 207
Palmer, Wm., of Rugeley, 80
Papworth Y7illage Settlement, 71,
261, 276, 290

Allbutt Memorial Cottages, 231
Presidency, 231
work at, 262, 264

SIR CLIFFORD ALLBUTT

311

Paracentesis pericardii, 14, 32,
42, 48, 240
Pare, Ambroise, 207
Paris, visit to, 171
Parry, Caleb Hillier, 176
Parsons, Franklin, 171
Pathological Society of Great
Britain and Ireland, 177
Pathology, comparative, 84, 93,
94, 110, 243, 250, 254, 265
Pavlov, I. P., 285
Payne, Joseph Frank, 121, 136,
201

Peacock, T. B., 46
Pearson, Karl, 243
Pennington, Sir Isaac, 106
People’s League of Health, 282
Periarteritis, syphilitic. 258
Pericardium, tapping of, 14, 32,
42, 48. 246
Perowne, E. H., 122
Pharmacology, examinations in,
131

Philip, Sir Robert, 147, 209
Philipson, Sir Geo. Hare, 10
Phillips, C. P., 97
Physicians, and a knowledge of
surgery, 32

and public welfare, 115
duties of, 115
fees of, 219, 220
Pitt-Lewis, G., 126
Playfair, Wm. Smoult, 87, 88,
120

Pleura, diseases of, 116
Pleuritic effusions, 14, 26, 72
Plumptre, Russell, 106
Pneumonia, 129
Pope, Sir W. J., 255
Portrait, 251, 295
Positivism, 12, 60
Post-graduate study, 145, 263
Powell, Sir Richard Douglas, 77,
129, 140, 154, 180, 193
Power, Sir D’Arcv, 272, 277
Preaching, 227, 242, 249, 252
Pregnancy, albuminuria and, 132
functional hemiplegia in, 49
Price, F. W., 269
Prior, Matthew, 212
Privy Councillor, 251
Prostatectomy, 259
Prout, W., 13
Psychological medicine, 99

Psychological Medicine, Cam¬
bridge Diploma in, 99, 204
Psycho-analysis, 99, 100, 267
Public Health Diplomas, 235
Pulmonary thrombosis, and em¬
bolism, 283, 284
Pulse, 68

Pulse tension, 134

Quakerism, 229, 230
Quarterly Journal of Medicine, 211
Quinine, antipyretic action of, 66

Radiology, 253

Diploma in, 235, 253
Ramazzini, Bernardino, 25
Raynaud, Maurice, 15
Reading habit, 28
Regius Professorship, 105
Relapsing fever, 21
Relativity, 228
Religion, and science, 227
Religious views, 227-229
Reynolds, Sir J. Russell, 117, 121,
129

Research in medicine, 208, 226,
236, 243, 250, 269, 296, 320
Rheumatoid arthritis, 181
Ringer, Sidney, 35
Ritchie, A. D., 275
Robert Boyle Lecture, 149
Robert, Rudolf, 128
Roberts, David Lloyd, 288
Roberts, R. D., 130
Roberts, Sir William, 26
Robertson, G. M., 286
Robson, Sir A. Mayo, 122, 279
Rome, visit to, 129, 142
Ross, Sir Ronald, 155, 165
Rothschild, M. A., 221
Routh, Amand, 132
Roux, Emile, 243
Roy, C. S., 117

Royal Army Medical Corps, 164
Royal College of Physicians,
Ireland, Honorary Fellow¬
ship, 140

Royal College of Physicians,
London, Censor, 224
Censors’ Board, 185, 186
Examinership, 141, 142
Fellowship, 84

Goulstonian Lectureship, 74,
75, 84, 86

312

SIR CLIFFORD ALLBUTT

Royal College of Physicians
( contd .) — -

Harveian Orator, 145
Honorary Fellows, 285
Membership, 74
Moxon Gold Medal, 259
the office of President, 225
Royal Medical and Chirurgical
Society, 92

Royal Society, Fellowship and
Committee work, 80
Royal Society of Medicine, 92
Honorary Fellow, 243
Rudolf, R.D., 286
Rutherford, Sir Ernest, 243, 285
Rynd’s syringe, 44

Sadler, Sir Michael, 3
St. Andrew’s Institute for Clini¬
cal Research, 69

St. Bartholomew’s Hospital Cele¬
bration, 271

St. David’s, Pembrokeshire, 102
St. George’s Hospital Medical
School, 12

St. Louis Exhibition, 165
Salisbury diet, 247
Salisbury, Lord, 109
Sanatoriums for tuberculosis, 262,
264

Sanctorius’ clinical thermometer,
34

Sarsaparilla, 48
Savage, Sir George H., 101
Savile Club, 100
Savill, T. D., 134
Scales, F. Shillington, 235
Scarlet fever, 67

Schools, “brain forcing” in, 73, 86.

See also Education
Schulze, Edmund, 36, 37, 82
Science, classics and, 217

function of, in education, 189,
217, 218

religion and, 227
Science and Medieval Thought, 146
Scientific papers, composition of,
159-163, 269
Scott, Sir Gilbert, 25
Scrofulous glands, 83, 90
Semon, Sir Felix, 165
Senile plethora, 128, 134, 137.

See also Hyperpiesia
Sex matters, 9i

Shattock, S. G., 243
Shaw, G. Bernard, 189
Shaw, Lauriston, 202
Shaw, T. Claye, 196
Sherrington, Sir Charles, 163, 243
Simeon, Charles, 9
Singer, Charles, 275
Skeat, W. W., 122
Skelton, Thomas, 5
Skin, nutrition of, 66
Smallpox, at Cambridge, 21
Smith, J. Lorrain, 147, 177, 205
Smoking, 282, 295
Society of Friends, 229
Speech, impairment of, 85
Spencer, Herbert Ritchie, 259,
289

Sphygmograph, 68
Spiritual life, 227-229
Spurgin, John, 35
Stanford University, 137
Stansfield, T., 30
Starling, E. II., 213
State medicine, 187
Stephen, Sir Fitzjames, 79
Stephen, Sir Leslie, 52, 101
Sterling, John, 29
Stomach, dilatation of, 77, 151
lavage of, 77
neuralgia of, 86
Stone, Marcus, 100
Strain, effect on the heart, 45, 46,
62

Strangeways, T. S. P., 181
Strangeways Research Labora¬
tories, 269
Sudhoff, Karl, 241
Suggestion and hypnotism, 103
“Sunday Tramps”, 52, 100, 101
Superannuation of Professors,
257

Surgeon’s fees, 219
Surgerv and Medicine, 83, 155,
166, 220

artificial distinction between,
32

Surgical aids to medicine, 77, 83
Survival of the fittest, 152, 156
Sutherland, G. A., 226
Symonds, John Addington, 71
Symptoms, treatment of, 198
Syncope, 251

Syphilis, and general paralysis, 98
of cerebral arteries, 40

SIR CLIFFORD ALLBUTT

313

Syphilis (contd.)—

of nervous system, 40, 42, 58,
64, 258

sarsaparilla in cachectic cases,
48

visceral, 258

Systcrn of Gynaecology, 120, 121
System of Medicine, 117, 118

Tabes dorsalis, 127
Tachycardia, 184, 185
Tadcaster, enteric fever at, 43
Talbot, Bishop, 228
Taylor, Charles Louis, 196
Taylor, Sir Frederick, 122, 224
Teale, T. Pridgin, sen., 23, 56, 81
Teale, T. Pridgin, jun., 24, 26,
27, 39, 44, 81, 88, 90, 122,
188, 198
death of, 278

Team work, pioneers of, 27
Temperature (body), effect of
physical exertion on, 56
surface recordings, 67
Tennyson, Lord, 29
“Tension”, 135
Tetanus, 52, 53
Thackrah, C. Turner, 25
Thayer, W. S., 22, 165, 209, 248
Theology, interest in, 228
“Theory” and “fact”, use of the
terms, 160, 203

Thermometer clinical, Allbutt's,
34-36, 49

history of, 34-36, 49, 55
Thermopile, clinical, 67
Theses, composition of, 159, 161,
162

Thomson, Sir J. J., 243
Thomson, Sir St. Clair, 142, 289
Thoracic surgery, 26, 59
Thorne, Sir R. Thorne, 43
Thorpe, Sir T. E., 24
Thrombosis, pulmonary, 283
typhoid, 22

Thruston Speech and Prize, 46,
47

Times, The, contributions to,
126, 135, 143, 149, 163, 167,
177, 179, 180, 196, 202, 217,
218, 243, 252, 256, 263, 278,
280, 286, 287, 292
Titles of medical papers, 191, 192
Tobacco, 282, 295

Toronto, visit to, 138, 177
Trcloar Hospital, Alton, 71, 273
Tropical Medicine and Hygiene
Diploma, 155

Trousseau, Armand, 14, 15, 18,
26, 123

on paracentesis pericardii, 48
Trudeau, E. L., 70
Tuberculosis, 147, 180, 191, 209
Davos treatment, 70, 71
dispensaries and sanatoriums
for, 261

in man and animals, 253
treatment, 140, 142, 151, 152,
262, 264. See also Papworth
Village Settlement.
Tuberculous glands, 90, 122
Turnbull, H. M., 216
Turner, Sir Wm., 57, 210
Tyndall, John, 85
“Type” and “typical”, use of the
terms, 161
Typhoid, 18, 83

infection by urine, 147
open-air treatment, 41
thrombosis in, 22, 284
Typhus, 18, 21

at Leeds (1865-66), 32-34
infection from the dead, 53
open-air treatment, 32-34, 41
prevention, 39

United States, visit to, 137, 165
Universities, in medical research
and practice, 250
modern, 252

University education, function
of, 113, 172
Uraemic asthma, 71
Uterine disease, 87

Van Horn, Sir William, 138
Van Swieten, 34

Varrier-Jones, P. C., 67, 163, 231,
261, 263, 276
Venn, John, 10
Vicious circles in disease, 198
Visceral neuroses, 86
Vitamins in bread, 292

Wade, Sir W. F., 102
Wagner, Hermann, 214
“ Waiting period ”, reading dur¬
ing, 28

314

SIR CLIFFORD ALLBUTT

Wakefield, West Riding Lunatic
Asylum, 40, 64, 97
Waller, A. D., 199
Walsham, Hugh, 176
Warfare, chemical, 255
Waring, Sir Holburt, 272
War work, 214, 221
Washbourn, J. W., 141 , 148
Waterton, Charles, 1
Watson, Sir Thomas, 212
Watts, G. F„ 100
Weber, Sir Hermann, 147, 154,
237

Webster, Sir Richard, 139
Wedgwoods, The, 1
Welch, W. H., 119, 138, 178, 248
Wellmann, Max, 134, 153
Wells, Sir Spencer, 56
Wenckebach, K. F., 197, 248,
258, 271, 284, 285
Wesley, Samuel Sebastian, 82
West, Samuel, 75
West London Medico-Chirurgical
Society, 272

West London Post-graduate Col¬
lege, 268

Wheelhouse, Claudius Galen, 14,
24, 32, 66, 80, 83, 88, 95, 102
appreciation of, 190
Wherry, G. E., 281
Whitehead, Walter, 151

Wilks, Sir Samuel, 31, 40, 49, 54
Williams, Sir Dawson, 265, 270
Williams, Rhys, 97
Wills, Mr. Justice Alfred, 100
Wilson, Edmund, 20
Winterton, Ralph, 107. 251
Wolf, C. G. L., 246
Womack, F. E., 188
Women, degrees for, 129, 130,
259

Wood, Alexander, 44
Wood-engraving, 23
Woodhead, Sir German Sims, 147,

177, 258

appreciation of, 260
Wooler, John, 2
Wooler, Margaret, 2, 3
Words, correct use of, 161, 162,

178, 191, 192, 272, 290

Worry, influence on kidnevs, 68,

69

Wright, Sir Almroth, 243
Writing, style in, 162, 163
Wunderlich, C. A., on clinical
thermometry, 35
Wuthering Heights, 4

York, St. Peter's School, 7, 8
Yorkshire, N. and E. Riding
Asylum, 57

W. Riding Asylum, 40, 64, 97

THE END

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